Objectives: To unravel the extent to which gender plays a role in the epidemiology, aetiology, risk of rupture and treatment of abdominal aortic aneurysms (AAAs) and to give an overview of these factors. Design, Materials and Methods: A literature review was performed in the Medline database and Cochrane Library for gender-specific articles on epidemiology, aetiology, risk of rupture and treatment of AAAs. Results: Our literature review suggests that the prevalence of AAA in women is underestimated. Regarding aetiology, an oestrogen-mediated reduction in macrophage MMP-9 production seems to be an important mechanism causing gender-related differences in AAA development. We found consensus in the literature that women run a greater risk of rupture compared to men under the current management rules for AAAs. Their treatment mortality also seems to be higher for both elective and ruptured repair. Conclusions: Gender-specific guidelines should be put into place for the management of AAAs and awareness for this disease should be increased, both in women themselves and in their doctors.

Additional Metadata
Keywords Abdominal aortic aneurysm, Aetiology, Epidemiology, Gender, Rupture, Treatment
Persistent URL dx.doi.org/10.1016/j.ejvs.2009.05.004, hdl.handle.net/1765/27001
Journal European Journal of Vascular and Endovascular Surgery
Grootenboer, N, Bosch, J.L.H.R, Hendriks, J.M, & van Sambeek, M.R.H.M. (2009). Epidemiology, Aetiology, Risk of Rupture and Treatment of Abdominal Aortic Aneurysms: Does Sex Matter?. European Journal of Vascular and Endovascular Surgery, 38(3), 278–284. doi:10.1016/j.ejvs.2009.05.004