Sex Differences in Outcomes Following Ruptured Abdominal Aortic Aneurysm Repair

Abstract

Sex-related differences play an important role in the natural history, diagnosis, and management of abdominal aortic aneurysm (AAA).¹ Although the prevalence of AAA is higher in men (7.6% vs 1.3%),² women experience more rapid AAA growth and a 4-fold higher risk of rupture.^3,4 Despite the more aggressive nature of aneurysm progression in women, there are major sex disparities in AAA management.^5,6 This difference is partly because women are underrepresented in clinical studies, limiting our understanding of the screening and treatment strategies in this population.^7-9 In the event of ruptured AAA (rAAA), women are less likely to be admitted to the hospital and receive operative intervention.^10-12 Overall, these factors contribute to higher AAA mortality rates among women compared with men.¹³ As a result, the Society for Vascular Surgery (SVS) recommends a lower diameter threshold for elective repair in women compared with men (5.0 vs 5.5 cm).¹⁴