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Updated: May 11, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Austrian national carotid intervention numbers prompt improvement in secondary stroke prevention
N Duschek1, T Waldhör, J Falkensammer
1Department of Vascular and Endovascular Surgery, Wilhelminenspital, Vienna, Montleartstrasse 37, Austria. nduschek@me.com
Insights
Carotid intervention rates in Austria stagnated despite rising stroke incidence. Carotid stenting (CAS) increased, particularly in elderly women, suggesting a need for better patient selection for stroke prevention.
Area of Science:
- Vascular Surgery
- Neurology
- Public Health
Background:
- Stroke prevention relies on careful patient selection for carotid interventions.
- Carotid endarterectomy (CEA) and carotid stenting (CAS) benefits are variable.
- Understanding intervention trends is crucial for optimizing stroke prevention strategies.
Purpose of the Study:
- To analyze Austrian carotid intervention rates (CEA and CAS) from 1999-2008.
- To assess if interventions aligned with epidemiological trends and published data.
- To evaluate intervention patterns by age, gender, and procedure type.
Main Methods:
- Retrospective analysis of national Austrian registry data (1999-2008).
- Data categorized by gender, age groups (0-64, 65-74, >75), and intervention type (CEA vs. CAS).
- Calculation of intervention rates per 100,000 persons annually.
Main Results:
- CEA rates were 32.2/100,000 annually (higher in men).
- CAS rates were 9.1/100,000 annually (similar in men and women).
- CAS numbers increased significantly, while CEA numbers stagnated, especially in older age groups. Women showed a higher propensity for CAS over CEA compared to men.
Conclusions:
- Carotid intervention rates have stagnated despite increasing stroke incidence in an aging population.
- CAS rates are rising, particularly among elderly women, despite controversial evidence.
- Improved secondary stroke prevention in Austria requires careful patient selection, considering gender and intervention type.
Background:
As recent data suggest a variable benefit of carotid endarterectomy (CEA) or stenting (CAS), a careful selection of patients is mandatory for efficient stroke prevention. This retrospective study analyzed carotid intervention rates from 1999-2008 in Austria. The aim was to assess whether interventions for carotid stenosis were performed with respect to epidemiological trends and published data taking into account intervention type, age and gender.
Methods:
Intervention numbers for internal carotid artery (ICA)-stenosis from a 10 years period (1999 to 2008) were retrieved from the national Austrian registry for hospital funding. Patients were grouped by gender, age (0-64, 65-74, older than 75 years) and intervention type.
Results:
CEA rates amounted to 32.2±1.4 per 100000 persons annually (female: 22.1±0.7, male: 43.0±2.3). Each year 9.1 CAS±1.6 per 100000 Austrians were performed (female: 9.3±1.8, male 8.9±1.7). CAS numbers increased (P<0.05), whereas CEA numbers stagnated, especially in older age groups. Women were more likely to undergo CAS than CEA compared to men.
Conclusion:
Relative intervention rates for carotid stenosis have rather stagnated, although stroke incidence increases continuously in an overaging society. Despite controversial data, CAS rates have been rising constantly in elderly women. Secondary stroke prevention in Austria can be improved by a careful selection of future patients, especially with regard to female gender and type of intervention.
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