Gender-based radiation exposure and clinical outcomes in peripheral endovascular intervention for limb ischemia: A prospective study

doi:10.4330/wjc.v17.i9.110220

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 17, Issue 9

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (0)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-1) series, Tables (1-3) series.

Item

Count

PDF

HTML

Figures (1-1)

Tables (1-3)

Sum=0

Sep 26, 2025 (publication date) through Sep 17, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Cardiology

ISSN

1949-8462

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study

World J Cardiol. Sep 26, 2025; 17(9): 110220
Published online Sep 26, 2025. doi: 10.4330/wjc.v17.i9.110220

Gender-based radiation exposure and clinical outcomes in peripheral endovascular intervention for limb ischemia: A prospective study

Subrata Kar, Clifton Espinoza

Subrata Kar, Clifton Espinoza, Division of Cardiology, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX 79905, United States

Author contributions: Kar S designed the research study, performed the research analyses, and analyzed the data; Kar S also wrote the manuscript; Kar S contributed to the editorial changes in the manuscript; Kar S read and approved the final manuscript; Espinoza C collected the data and approved the final manuscript.

Institutional review board statement: This study was approved by the Institutional Review Board and the Ethics Committee at Texas Tech University El Paso, El Paso, TX, United States.

Clinical trial registration statement: The prospective study was performed without the use of new medications, novel drugs, or novel devices/equipment. Thus, the study does not meet criteria nor require clinical trials registration.

Informed consent statement: All study participants, or their legal guardians, provided written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: There is no additional data available.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Subrata Kar, D.O., RPVI, FACC, FSCAI, Division of Cardiology, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, 4801 Alberta Ave, El Paso, TX 79905, United States. skar762@aim.com

Received: June 3, 2025
Revised: July 3, 2025
Accepted: August 14, 2025
Published online: September 26, 2025
Processing time: 108 Days and 5.5 Hours

Abstract

BACKGROUND

Peripheral endovascular intervention (PEVI) is performed using radiation. Radiation has deleterious health consequences for patients and operators.

AIM

To investigate the gender radiation disparities and procedural outcomes in PEVI.

METHODS

A prospective observational study was performed in 186 consecutive patients (65 ± 12 years) at an academic medical center from January 2019 to April 2020 (mean follow-up of 3.9 ± 3.6 months) comparing the gender radiation disparity and outcomes of PEVI (n = 147 underwent intervention, 79.0%). Groups were divided into women (n = 99, 53.2%) and men (n = 87, 48.4%). Primary endpoints included air kerma, dose area product (DAP), fluoroscopy time, and contrast use. Secondary endpoints included all-cause mortality, acute myocardial infarction, acute kidney injury, stroke, repeat revascularization, major adverse limb event, and the composite of complications.

RESULTS

Men showed increased DAP compared with women (15221.2 ± 25858.5 µGy × m²vs 9251.7 ± 9555.3 µGy × m², P = 0.047), but no significant difference in air kerma or any other primary endpoints. In the secondary endpoints, no significant difference was found between gender.

CONCLUSION

Men had increased DAP indicating more radiation absorption in the exposed area. Gender outcomes showed no difference in complications. Thus, PEVI can be safely performed in men or women.

Keywords: Endovascular intervention; Peripheral arterial disease; Peripheral vascular disease; Radiation; Acute limb ischemia; Critical limb ischemia; Chronic total occlusion; Vascular access; Venous occlusion

Core Tip: Radiation is harmful to patients and operators. During peripheral angiogram and peripheral endovascular intervention (PEVI), radiation is produced. Our study showed that men had a greater dose area product compared with women, but no difference in procedural outcomes. These findings are important, so that we may consider more radiation prudent practices in men to minimize the patient’s and operator’s radiation exposure. Such a study has not been previously conducted in PEVI and provides important real-world information.