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Geschlechtsspezifische Unterschiede in der Gefäßchirurgie

Gender-specific differences in vascular surgery

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Zusammenfassung

Geschlechtsspezifische Unterschiede in der Gefäßchirurgie wurden in den letzten Jahren vielfach vernachlässigt. Dabei lassen sich bei vielen klinisch bedeutenden Gefäßerkrankungen Besonderheiten hinsichtlich Epidemiologie, klinischer Manifestation, Therapieergebnissen und damit Indikationstellung im Geschlechtervergleich feststellen. Gefäßerkrankungen treten insgesamt häufiger bei Männern und später bei Frauen auf. Die getABI-Studie zeigte z. B. bei Männern eine höhere absolute Dreijahresmortalität als bei Frauen; die relative Dreijahresmortalität (Vergleich mit/ohne AVK) war in Bezug auf die Ereignisse „kardiovaskulärer Tod“ und „zerebrovaskulärer Tod“ bei Frauen wiederum größer als bei Männern. Auch die Krankheitsverläufe z. B. bei Aortenerkrankungen selbst unterscheiden sich: So weisen Frauen z. B. bei Aortendissektionen sowohl im Spontanverlauf als auch nach erfolgter Therapie eine erhöhte Komplikationsrate auf. Im Langzeitverlauf nach 5 Jahren ist bei Frauen nach Operation eines abdominellen Aortenaneurysmas (AAA) die Mortalität höher. Erklärt wird dies mit einer höheren Komorbidität bei Frauen. Frauen mit symptomatischer Karotisstenose profitieren lediglich innerhalb der ersten 2 Wochen (Männer 12 Wochen) nach Auftreten der Symptomatik von einer Operation. Bei asymptomatischen Patienten zeigt die Operation für Frauen zudem einen geringeren protektiven Effekt. Die geschlechtsspezifische Pharmakokinetik relevanter Begleitmedikamente in der Gefäßmedizin und deren Einfluss auf die Therapieergebnisse bei Gefäßerkrankungen werden ebenfalls bisher unterschätzt. Geschlechtsunterschiede in der Gefäßchirurgie werden in Zukunft stärker berücksichtigt werden müssen; sie werden sowohl die Indikationsstellung als auch die Patientenselektion für operative und interventionelle Eingriffe sowie deren Nachbeobachtungen beeinflussen.

Abstract

Men and women are different, even with respect to blood vessels. Gender-specific differences concerning vascular pathologies have not been given much consideration so far. However, with respect to clinically relevant vascular pathologies, there are obvious characteristics in the comparison of gender in terms of epidemiology, prevalence, clinical manifestation, therapy outcome and hence indications for treatment. Vascular disease is more frequent in men and has a later onset in women. The getABI study revealed a higher absolute 3-year mortality in men than in women. The relative 3-year mortality (comparison with/without arterial occlusion) was higher in women than in men in terms of cardiovascular and cerebrovascular death. The disease courses are also different, insofar as women for example have a higher complication rate after aortic dissections, both in the spontaneous course and after treatment. In the long term after 5 years, women have a higher mortality rate following surgical treatment of an abdominal aortic aneurysm. The higher incidence of comorbidities in women is considered to explain this difference. If appropriate, women must be monitored longer in intensive care after high-risk operations, which include interventions on the aorta. Women with carotid stenosis are less likely to suffer a stroke. However, they only benefit from surgery during the first 2 weeks (for men 12) after the initial symptoms. Moreover surgery at asymptomatic status has less protective effect regarding female patients. The gender specificity of the pharmacokinetics of relevant medications and their influence on the results of vascular surgery has been underestimated up to now. In future, more emphasis must be given to these differences and they must be taken account of in decisions as to whether or not operative and interventional treatments are indicated and in the intensity and duration of patient monitoring after such treatment.

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Literatur

  1. Katz DJ, Stanley JC, Zelenock GB (1997) Gender differences in abdominal aortic aneurysm prevalence, treatment, and outcome. J Vasc Surg 25:561–568

    Article  PubMed  CAS  Google Scholar 

  2. Norman PE, Powell JT (2007) Abdominal aortic aneurysm: the prognosis in women is worse than in men. Circulation 115:2865–2869

    Article  PubMed  CAS  Google Scholar 

  3. Norman PE, Semmens JB, Lawrence-Brown M, Holman CD (2000) The influence of gender on outcome following peripheral vascular surgery: a review. Cardiovasc Surg 8:111–115

    Article  PubMed  CAS  Google Scholar 

  4. Roddy SP, Darling RC III, Maharaj D et al (2003) Gender-related differences in outcome: an analysis of 5880 infrainguinal arterial reconstructions. J Vasc Surg 37:399–402

    Article  PubMed  Google Scholar 

  5. Sarac TP, Hertzer NR, Mascha EJ et al (2002) Gender as a primary predictor of outcome after carotid endarterectomy. J Vasc Surg 35:748–753

    Article  PubMed  Google Scholar 

  6. Volkmann S, Schönmetzler M, Taute BM, Poghaisky H (2007) Geschlechtsunterschiede in Manifestation und Risikoprofil der peripheren Verschlusskrankheit. Perfusion 20:152–157

    Google Scholar 

  7. Wenger NK (2002) Coronary heart disease and women: magnitude of the problem. Cardiol Rev 10:211–213

    Article  PubMed  Google Scholar 

  8. Hinrichs A (2007) Gender differences in vascular medicine. Vasa 36:5–16

    Article  PubMed  CAS  Google Scholar 

  9. Lampert T, Burger M (2004) Rauchgewohnheiten in Deutschland. Gesundheitswesen 66:511–517

    Article  PubMed  CAS  Google Scholar 

  10. Gasse C, Hense HW, Stieber J et al (2001) Assessing hypertension management in the community: trends of prevalence, detection, treatment, and control of hypertension in the MONICA Project, Augsburg 1984–1995. J Hum Hypertens 15:27–36

    Article  PubMed  CAS  Google Scholar 

  11. Ariyo AA, Thach C, Tracy R (2003) Lp(a) lipoprotein, vascular disease, and mortality in the elderly. N Engl J Med 349:2108–2115

    Article  PubMed  CAS  Google Scholar 

  12. Higgins JP, Higgins JA (2003) Epidemiology of peripheral arterial disease in women. J Epidemiol 13:1–14

    Article  PubMed  Google Scholar 

  13. Kent DM, Price LL, Ringleb P et al (2005) Sex-based differences in response to recombinant tissue plasminogen activator in acute ischemic stroke: a pooled analysis of randomized clinical trials. Stroke 36:62–65

    Article  PubMed  CAS  Google Scholar 

  14. Hertzer NR, Bena JF, Karafa MT (2007) A personal experience with direct reconstruction and extra-anatomic bypass for aortoiliofemoral occlusive disease. J Vasc Surg 45:527–535

    Article  PubMed  Google Scholar 

  15. Schwartz JB (2003) Gender-specific implications for cardiovascular medication use in the elderly optimizing therapy for older women. Cardiol Rev 11:275–298

    Article  PubMed  Google Scholar 

  16. Heart Protection Study Collaborative Group (2002) MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 360:23–33

    Article  Google Scholar 

  17. Gresser U, Gathof BS (2004) Atorvastatin: gold standard for prophylaxis of myocardial ischemia and stroke – comparison of the clinical benefit of statins on the basis of randomized controlled endpoint studies. Eur J Med Res 9:1–17

    PubMed  CAS  Google Scholar 

  18. Dale KM, Coleman CI, Shah SA et al (2007) Shah SA Impact of gender on statin efficacy. Curr Med Res Opin 23(3):565–574

    Article  PubMed  CAS  Google Scholar 

  19. Ridker PM, Cook NR, Lee IM et al (2005) A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 352(13):1293–1304

    Article  PubMed  CAS  Google Scholar 

  20. Baigent C, Blackwell L, Collins R et al (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373:1849–1860

    Article  PubMed  Google Scholar 

  21. Berger JS, Bhatt DL, Cannon CP et al (2009) The relative efficacy and safety of clopidogrel in women and men a sex-specific collaborative meta-analysis. J Am Coll Cardiol 54:1935–1945

    Article  PubMed  CAS  Google Scholar 

  22. Lonn E, Roccaforte R, Yi Q et al (2002) Effect of long-term therapy with ramipril in high-risk women. J Am Coll Cardiol 40:693–702

    Article  PubMed  CAS  Google Scholar 

  23. Cheanvechai V, Harthun NL, Graham LM et al (2004) Incidence of peripheral vascular disease in women: is it different from that in men? J Thorac Cardiovasc Surg 127:314–317

    Article  PubMed  Google Scholar 

  24. Vollmar J (1996) Rekonstruktive Chirurgie der Arterien, 4. Aufl. Thieme, Stuttgart

  25. Gallagher KA, Meltzer AJ, Ravin RA et al (2011) Gender differences in outcomes of endovascular treatment of infrainguinal peripheral artery disease. Vasc Endovascular Surg 45:703–711

    Article  PubMed  Google Scholar 

  26. Morris-Stiff G, Ogunbiyi S, Rees J et al (2011) Variations in the anatomical distribution of peripheral vascular disease according to gender. Ann R Coll Surg Engl 93:306–309

    Article  PubMed  Google Scholar 

  27. Pulli R, Dorigo W, Pratesi G et al (2012) Gender-related outcomes in the endovascular treatment of infrainguinal arterial obstructive disease. J Vasc Surg 55:105–112

    Article  PubMed  Google Scholar 

  28. Brewster DC, Darling RC (1978) Optimal methods of aortoiliac recontruction. Surgery 84:739–748

    PubMed  CAS  Google Scholar 

  29. McDermott MM, Greenland P, Liu K et al (2003) Sex differences in peripheral arterial disease: leg symptoms and physical functioning. J Am Geriatr Soc 51:222–228

    Article  PubMed  Google Scholar 

  30. Murabito JM, D’Agostino RB, Silbershatz H, Wilson WF (1997) Intermittent claudication. A risk profile from The Framingham Heart Study. Circulation 96:44–49

    PubMed  CAS  Google Scholar 

  31. Jernigan WR, Fallat ME, Hatfield DR (1983) Hypoplastic aortoiliac syndrome: An entity peculiar to women. Surgery 94:752–757

    PubMed  CAS  Google Scholar 

  32. Diehm C, Kareem S, Lawall H (2004) Epidemiology of peripheral arterial disease. Vasa 33:183–181

    Article  PubMed  CAS  Google Scholar 

  33. Diehm C (2006) Frauen(herzen) sind anders… Cardiovasc 1:12–15

    Google Scholar 

  34. Vouyouka AG, Kent KC (2007) Arterial vascular disease in women. J Vasc Surg 46:1295–1302

    Article  PubMed  Google Scholar 

  35. Egorova N, Vouyouka AG, Quin J et al (2010) Analysis of gender-related differences in lower extremity peripheral arterial disease. J Vasc Surg 51:372–378.e1

    Article  PubMed  Google Scholar 

  36. Vouyouka AG, Egorova NN, Salloum A et al (2010) Lessons learned from the analysis of gender effect on risk factors and procedural outcomes of lower extremity arterial disease. J Vasc Surg 52:1196–1202

    Article  PubMed  Google Scholar 

  37. Nguyen LL, Bandyk DF, Belkin M et al (2007) Female gender and oral anticoagulants are associated with wound complications in lower extremity vein bypass: an analysis of 1404 operations for critical limb ischemia. J Vasc Surg 46:1191–1197

    Article  PubMed  Google Scholar 

  38. Flu HC, Ploeg AJ, Marang-van de Mheen PJ et al (2010) Patient and procedure related risk factors for adverse events after infrainguinal bypass. J Vasc Surg 51:622–627

    Article  PubMed  Google Scholar 

  39. Sharafuddin MJ, Hoballah JJ, Kresowik TF et al (2008) Long-term outcome following stent reconstruction of the aortic bifurcation and the role of geometric determinants. Ann Vasc Surg 22:346–357

    Article  PubMed  Google Scholar 

  40. Adam DJ, Beard JD, Cleveland T et al (2005) Bypass versus angioplasty in severe ischemia of leg (BASIL): multicentre, randomised controlled trial. Lancet 366:1925–1934

    Article  PubMed  CAS  Google Scholar 

  41. Gesundheitsberichterstattung des Bundes (2006) Schlaganfall Kapitel 1.2.2.2 [Gesundheit in Deutschland, 2006]. https://www.gbe-bund.de/gbe10/abrechnung.prc_abr_test_logon?p_uid=gasts&p_aid=&p_knoten=FID&p_sprache=D&p_suchstring=10404::Schlaganfall

  42. Barrett KM, Brott TG, Brown RD Jr et al (2007) Sex differences in stroke severity, symptoms, and deficits after first-ever ischemic stroke. J Stroke Cerebrovasc Dis 16:34–39

    Article  PubMed  Google Scholar 

  43. Di Carlo A, Lamassa M, Baldereschi M et al (2003) Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital based registry. Stroke 34:1114–1119

    Article  Google Scholar 

  44. Grau AJ, Weimar C, Buggle F et al (2001) Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke 32:2559–2566

    Article  PubMed  CAS  Google Scholar 

  45. Hillen T, Nieczaj R, Munzberg H et al (2000) Carotid atherosclerosis, vascular risk profile and mortality in a population-based sample of functionally healthy elderly subjects: the Berlin ageing study. J Intern Med 247:679–688

    Article  PubMed  CAS  Google Scholar 

  46. Bonita R (1992) Epidemiology of stroke. Lancet 339:342–344

    Article  PubMed  CAS  Google Scholar 

  47. Fisher M, Martin A, Cosgrove M, Norris JW (1993) The NASCET-ACAS plaque project. North American Symptomatic Carotid Endarterectomy Trial. Asymptomatic Carotid Atherosclerosis Study. Stroke 24:I24–I25

    Article  PubMed  CAS  Google Scholar 

  48. Halliday A, Harrison M, Hayter E et al (2010) 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial. Lancet 376:1074–1084

    Article  PubMed  Google Scholar 

  49. Chambers BR, Donnan GA (2005) Carotid endarterectomy for asymptomatic carotid stenosis. Cochrane Database Syst Rev:CD001923

    Google Scholar 

  50. Barrett KM, Brott TG, Brown RD Jr et al (2007) Sex differences in stroke severity, symptoms, and deficits after first-ever ischemic stroke. J Stroke Cerebrovasc Dis 16:34–39

    Article  PubMed  Google Scholar 

  51. Grootenboer N, Hunink MG, Hoeks S et al (2011) The impact of gender on prognosis after non-cardiac vascular surgery. Eur J Vasc Endovasc Surg 42:510–516

    Article  PubMed  CAS  Google Scholar 

  52. Böckler D, Attigah N, Hakimi M, Allenberg JR (2009) ACST – Eine Studie wird zum Problem. Gefässchirurgie 14:118–122

    Article  Google Scholar 

  53. Goldstein LJ, Khan HU, Sambol EB et al (2009) Carotid artery stenting is safe and associated with comparable outcomes in men and women. J Vasc Surg 49:315–323

    Article  PubMed  Google Scholar 

  54. Spyris CT, Vouyouka AG, Tadros RO et al (2012) Sex-related differences in embolic potential during carotid angioplasty and stenting. Ann Vasc Surg 26:93–101

    Article  PubMed  Google Scholar 

  55. North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325(7):445–453

    Article  Google Scholar 

  56. ECST Group (1998) Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 351:1379–1387

    Article  Google Scholar 

  57. Rothwell PM, Eliasziw M, Gutnikov SA et al (2004) Sex difference in the effect of time from symptoms to surgery on benefit from carotid endarterectomy for transient ischemic attack and nondisabling stroke. Stroke 35:2855–2861

    Article  PubMed  CAS  Google Scholar 

  58. Hata A, Noda M, Moriwaki R, Numano F (1996) Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol 54(Suppl):S155–S163

    Article  PubMed  Google Scholar 

  59. Lupi-Herrera E, Sanches-Torres G, Horwitz S (1975) Pulmonary artery involvement in Takayasu’s arteritis. Chest 67:69–74

    Article  Google Scholar 

  60. Ueno A, Awane Y, Wakabayashi A, Shimizu K (1967) Successfully operated obliterative brachiocephalic arteritis (Takayasu) associated with the elongated coarctation. Jpn Heart J 8:538–544

    Article  PubMed  CAS  Google Scholar 

  61. Cronenwett JL, Johnston KW (eds) (2010) Rutherford’s Vascular Surgery, 7th ed. Saunders Elsevier, Philadelphia, p 1187

  62. Vardulaki KA, Walker NM, Day NE (2000) Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. Br J Surg 87(2):195–200.

    Article  PubMed  CAS  Google Scholar 

  63. Ockert S, Schumacher H, Bockler D et al (2007) Early and midterm results after open and endovascular repair of ruptured abdominal aortic aneurysms in a comparative analysis. J Endovasc Ther 14:324–332

    Article  PubMed  Google Scholar 

  64. Semmens JB, Norman PE, Lawrence-Brown MM, Holman CD (2000) Influence of gender on outcome from ruptured abdominal aortic aneurysm. Br J Surg 87:191–194

    Article  PubMed  CAS  Google Scholar 

  65. Böckler D, Schumacher H, Allenberg JR (2005) Vascular surgery in the elderly. Chirurg 76:113–125

    Article  PubMed  Google Scholar 

  66. Ouriel K, Greenberg RK, Clair DG et al (2003) Endovascular aneurysm repair: gender-specific results. J Vasc Surg 38:93–98

    Article  PubMed  Google Scholar 

  67. Hugl B, Hakaim AG, Biebl M et al (2007) Impact of gender on the outcome of endovascular aortic aneurysm repair using the Zenith stent-graft: midterm results. J Endovasc Ther 14:115–121

    Article  PubMed  Google Scholar 

  68. Solberg S, Singh K, Wilsgaard T (2005) Increased growth rate of abdominal aortic aneurysms in women. The Tromsø study. Eur J Vasc Endovasc Surg 29(2):145–149

    Article  PubMed  CAS  Google Scholar 

  69. Kent KC, Zwolak RM, Jaff MR et al (2004) Screening for abdominal aortic aneurysm: a consensus statement. J Vasc Surg 39:267–269

    Article  PubMed  Google Scholar 

  70. Böckler D, Hyhlik-Dürr A, von Tengg-Kobligk H et al (2007) Klinische Anforderungen an die Bildgebung der Aorta. Radiologe 47:962–973

    Article  PubMed  Google Scholar 

  71. Derubertis BG, Trocciola SM, Ryer EJ et al (2007) Abdominal aortic aneurysm in women: prevalence, risk factors, and implications for screening. J Vasc Surg 46:630–635

    Article  PubMed  Google Scholar 

  72. Wanhainen A, Lundkvist J, Bergqvist D, Björck M (2006) Cost-effectiveness of screening women for abdominal aortic aneurysm. J Vasc Surg 43(5):908–914

    Article  PubMed  Google Scholar 

  73. Scott RA, Bridgewater SG, Ashton HA (2002) Randomized clinical trial of screening for abdominal aortic aneurysm in women. Br J Surg 89:283–285

    Article  PubMed  CAS  Google Scholar 

  74. Hultgren R, Granath F, Swedenborg J (2007) Different disease profiles for women and men with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 33:556–560

    Article  PubMed  CAS  Google Scholar 

  75. Böckler D, Schumacher H, Ockert S et al (2003) Akute und chronisch expandierende Aortendissektion Typ Stanford B – Verändert die endovaskuläre Therapie die Indikationsstellung? Gefässchirurgie 8:192–199

    Article  Google Scholar 

  76. Clouse WD, Hatlett JW, Schaff HV et al (2004) Acute aortic dissection: population based incidence compared with degenerative aortic aneurysm rupture. Mayo Clin Proc 79:176–180

    Article  PubMed  Google Scholar 

  77. Meszaros I, Morocz J, Szlavi J et al (2000) Epidemiology and clinicopathology of aortic dissection. Chest 117:1271–1278

    Article  PubMed  CAS  Google Scholar 

  78. Tsai TT, Nienaber CA, Eagle KA (2005) Acute aortic syndromes. Circulation 112:3802–3813

    Article  PubMed  Google Scholar 

  79. Nienaber CA, Fattori R, Mehta RH et al (2004) Gender-related differences in acute aortic dissection. Circulation 109:3014–3021

    Article  PubMed  Google Scholar 

  80. Steinmann B, Royce PM, Superti-Furga A (1993) The Ehlers-Danlos-Syndrome. In: Royce PM, Steinmann B (eds) Connective Tissue and Its Heritable Disorders: Molecular, Genetic, and Medical Aspects. Wiley-Liss, New York, pp 351–407

  81. Nienaber CA, Eagle KA (2003) Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies. Circulation 108:628–635

    Article  PubMed  Google Scholar 

  82. Rabe E, Pannier-Fischer F, Bromen K et al (2003) Bonner Venenstudie der Deutschen Gesellschaft für Phlebologie – epidemiologische Untersuchung der Frage der Häufigkeit und Ausprägung von chronischen Venenerkrankungen in der städtischen und ländlichen Wohnbevölkerung. Phlebologie 32:1–14

    Google Scholar 

  83. Maurins U, Hoffmann BH, Losch C et al (2008) Distribution and prevalence of reflux in the superficial and deep venous system in the general population – results from the Bonn Vein Study, Germany. J Vasc Surg 48:680–687

    Article  PubMed  Google Scholar 

  84. Carpentier PH, Maricq HR, Biro C (2004) Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France. J Vasc Surg 40(4):650–659

    Article  PubMed  Google Scholar 

  85. Fiebig A, Krusche P, Wolf A et al (2010) Heritability of chronic venous disease. Hum Genet 127:669–674

    Article  PubMed  Google Scholar 

  86. Criqui MH, Jamosmos M, Fronek A et al (2003) Chronic venous disease in an ethnically diverse population: the San Diego Population Study. Am J Epidemiol 158:448–456

    Article  PubMed  Google Scholar 

  87. Evans CJ, Fowkes FG, Ruckley CV, Lee AJ (1999) Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health 53:149–153

    Article  PubMed  CAS  Google Scholar 

  88. Ruckley CV, Evans CJ, Allan PL et al (2002) Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. J Vasc Surg 36:520–525

    Article  PubMed  Google Scholar 

  89. Robertson L, Evans C, Fowkes FG (2008) Epidemiology of chronic venous disease. Phlebology 23:103–111

    Article  PubMed  CAS  Google Scholar 

  90. Brand FN, Dannenberg AL, Abbott RD, Kannel WB (1988) The epidemiology of varicose veins: the Framingham Study. Am J Prev Med 4:96–101

    PubMed  CAS  Google Scholar 

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  1. Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Chirurgische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    A.S. Peters, C.M. Wieker, M. Hakimi & D. Böckler

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Peters, A., Wieker, C., Hakimi, M. et al. Geschlechtsspezifische Unterschiede in der Gefäßchirurgie. Gefässchirurgie 17, 143–157 (2012). https://doi.org/10.1007/s00772-012-1000-0

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