Peripheral Artery Disease and Gender: Systematic Review with ☸SAIMSARA

This paper aims to synthesize current evidence regarding the association between gender and peripheral artery disease (PAD), specifically evaluating differences in prevalence, risk factor profiles, clinical management, procedural outcomes, and limb-related complications across diverse patient populations. The review utilises 209 original studies with 3925814 total participants (ΣN). The evidence suggests a consistent gender-based treatment and outcomes gap: women are less likely to receive guideline-directed pharmacotherapy and vascular specialist care, and often experience higher perioperative morbidity, bleeding, stroke, and repeat revascularization, whereas men more often show greater hospitalized burden, PAD-related mortality, and amputation risk in PAD/diabetes cohorts. Findings on prevalence remain context-dependent, with some screening studies indicating higher ABI-defined PAD prevalence in women despite higher absolute burden in men. These findings support gender-tailored case-finding, risk-factor management, and perioperative counseling, while highlighting the need for more consistent sex-stratified reporting in vascular research.