Epidemiologie und Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) unter Genderaspekten

Objective: This literature review comments on gender differences for prevalence, epidemiology, risk factors and therapy in patients with peripheral arterial occlusive disease (PAOD). Material and methods: For the literature review Medline (PubMed) was searched for relevant studies on PAOD before December 2013. Keywords used were "peripheral arterial disease", "gender", "bypass", "intervention" and "outcome". Results: Women have a higher age-adjusted risk for PAOD and for women it is more often asymptomatic so that the disease is treated at an advanced stage. According to some studies women receive secondary prophylactic measures and interventional or surgical treatment less often than men. In addition, they suffer more frequently from bypass failure, impaired wound healing, bleeding complications and amputation. On the other hand, studies after infrainguinal reconstruction show similar patency and limb salvage rates to men and the differences for subsequent endovascular therapy are also only marginal. Possible reasons for the differences may be, besides the gender-specific cardiovascular risk profile, the estrogen concentration and different anatomical conditions with different vessel calibres. Conclusion: In PAOD there are gender differences. Clear guidelines for gender-specific treatment recommendations do not exist; however, they would be important for the long-term therapeutic success.