Gender-based outcomes after eversion carotid endarterectomy from 1998 to 2009
Claudio Baracchini1, Marina Saladini, Renata Lorenzetti
1Department of Neurological Sciences, University of Padua, School of Medicine, Padova, Italy.
Journal of Vascular Surgery
|November 23, 2011
Summary
Gender does not impact outcomes after eversion carotid endarterectomy (eCEA). This study found no significant differences in perioperative or long-term stroke-free survival and overall survival rates between men and women undergoing eCEA.
Area of Science:
- Vascular Surgery
- Cardiovascular Disease
- Neurosurgery
Background:
- Carotid endarterectomy (CEA) reduces stroke risk, but gender-based outcome differences are debated.
- Eversion CEA (eCEA) is a specific surgical technique for carotid artery disease.
Purpose of the Study:
- To investigate the influence of female gender on perioperative and long-term outcomes following eversion carotid endarterectomy (eCEA).
Main Methods:
- Analysis of a prospectively compiled database of consecutive eCEAs performed between September 1998 and December 2009.
- Evaluation of perioperative (30-day) death and stroke rates.
- Assessment of long-term carotid restenosis, occlusion, stroke-free survival, and overall survival rates with high follow-up compliance.
Main Results:
- Women (31.6%) had different cardiovascular risk profiles, including older age and higher rates of hypertension and hyperlipidemia.
- Perioperative stroke risk (0.6% vs 0.5%) and late restenosis/occlusion rates (1.1% vs 0.4%) were comparable between genders.
- Seven-year stroke-free survival (98.3% vs 98.8%) and overall survival (87.2% vs 93.8%) showed no significant gender-based differences.
Conclusions:
- Despite distinct cardiovascular risk profiles, female gender does not adversely affect perioperative or long-term outcomes after eversion carotid endarterectomy.
- eCEA is a safe and effective procedure for both men and women, irrespective of baseline risk factors.