Gender disparity in thoracic aneurysm repair linked to device size

CHICAGO–Women are more likely than men to suffer complications, including death, from a minimally invasive vascular surgical procedure. The reason: surgical devices too large for women’s anatomy, according to a new study in Journal of Vascular Surgery

“This study is a call to action to decrease device size to improve outcomes for women,” said Dr. Christopher Abularrage, assistant professor of surgery at Johns Hopkins University and one of the study’s investigators. 

Researchers reviewed 2005-2011 data on thoracic endovascular aortic repair (TEVAR), a minimally invasive procedure to treat a life-threatening ballooning of the aorta in the chest. They found that women were nearly three times as likely to require more invasive procedures during surgery, significantly increasing their risk of death. Researchers also found that women had longer operative times and were at greater risk for bleeding. An abstract of the study is available at A fact sheet on thoracic aneurysms and their repair is available here.

“With the device size of TEVAR delivery systems and women’s generally smaller iliac arteries, women are more likely to have complicated access issues that directly result in increased blood loss and death,” said Dr. Abularrage. 

Thoracic aortic aneurysm affects 15,000 Americans each year. Previous studies have shown that women are at greater risk for death after minimally invasive surgical repair of these aneurysms, but until now, there has been no well-designed study to identify the cause of this gender disparity. 

“Everyone had an inkling, but now we have proof that device size is an issue,” said Dr. Julie Freischlag, chair of the department of surgery at Johns Hopkins University, one of the study’s investigators and president of the Society for Vascular Surgery. “One of the early challenges in treating vascular disease in women was recognizing the illness—for a long time we believed being female protected against vascular disease. Now we’re past that and realize that there is a whole population of patients that could be treated better with devices better matched to their anatomy.”

About Journal of Vascular Surgery

The Journal of Vascular Surgery is a peer-reviewed scientific publication of the Society for Vascular Surgery, covering the most recent research in vascular surgery. For more information, please visit the journal’s website.

About the Society for Vascular Surgery

The Society for Vascular Surgery is a professional medical society dedicated to improving vascular health. The society is an advocate for vascular surgeons and the patients they care for. It counts more than 4,600 medical professionals as members, including surgeons, physicians and nurses. For more information about vascular health and the society, please visit the society's website.