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Gender and carotid endarterectomy: does it matter?
C M Akbari1, M C Pulling, F B Pomposelli
1Division of Vascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Journal of Vascular Surgery
|June 8, 2000
Summary
Female gender is not a risk factor for stroke, death, or cardiac morbidity after carotid endarterectomy (CEA). This study found no increased risk for women undergoing CEA, despite differences in cardiac risk factors and presentation.
Area of Science:
- Vascular Surgery
- Cardiovascular Disease
- Neurosurgery
Background:
- Previous studies suggested female gender as a risk factor for perioperative stroke and death after carotid endarterectomy (CEA).
- Understanding gender-specific risks is crucial for optimizing patient outcomes after CEA.
Purpose of the Study:
- To investigate whether female gender is associated with increased risk of perioperative stroke, death, or cardiac morbidity after CEA.
- To evaluate gender differences in risk factors, presentation, and outcomes following CEA.
Main Methods:
- Retrospective analysis of data from 1298 patients who underwent CEA between January 1990 and December 1998.
- Comparison of outcomes including stroke, death, cardiac events, and recurrent stenosis between male and female patients.
Main Results:
- Female patients (40%) had different cardiac risk factors (more diabetes, hypertension) and were more likely to be asymptomatic than men (60%).
- No significant differences were observed in postoperative stroke rates (1.2% women vs. 1.7% men), overall cardiac events (2.5% women vs. 1.5% men), or operative mortality (0.2% women vs. 0.4% men) between genders.
- Rates of late recurrent stenosis were also similar between men and women (1.5% vs. 0.8%).
Conclusions:
- Female gender is not a risk factor for stroke, death, or cardiac morbidity following carotid endarterectomy.
- Despite variations in risk factors and presentation, women do not face a higher risk of adverse outcomes or reoperation for recurrent stenosis after CEA.