| Gender-based outcomes after eversion carotid endarterectomy from 1998 to 2009. | |
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MedLine Citation:
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PMID: 22104344 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Although the benefit of carotid endarterectomy (CEA) in reducing the risk of stroke in selected symptomatic and asymptomatic patients has been well documented, the higher incidence of adverse events after CEA for women than for men remains controversial. The purpose of this study was to analyze the effect of female gender on perioperative (30-day) and long-term outcomes after eversion CEA (eCEA). METHODS: Patients entered into a prospectively compiled computerized database of all primary consecutive eCEAs performed at our institution from September 1998 to December 2009 were analyzed. Endpoints were perioperative death and stroke, late carotid restenosis or occlusion, and long-term freedom from stroke and survival rates. Long-term follow-up was obtained in 96.8% of patients (97.5% of the women). RESULTS: Among 1294 patients who underwent 1458 eCEAs under general anesthesia with continuous electroencephalographic monitoring and selective shunting, 409 (31.6%) were women (466 eCEAs). More women than men were over 80 years old (P = .001), and female patients were more likely to have arterial hypertension (P = .02) or hyperlipidemia (P = .006) than male patients. Preoperative statin medication (P = .01), contralateral carotid occlusion (P = .02), and shunting use (P = .03) were more frequent among female patients. No perioperative deaths occurred in the series as a whole, while the perioperative stroke risk (0.6% vs 0.5%), and the combined late carotid restenosis and occlusion rate (1.1% vs 0.4%) were comparable between female and male patients. The 7-year stroke-free survival and overall survival rates did not differ significantly between female and male patients (98.3% vs 98.8% and 87.2% vs 93.8%, respectively). CONCLUSIONS: This single-center university hospital study shows that although women have a different cardiovascular risk profile from men when they undergo eCEA, there is no evidence of a different gender effect on perioperative and long-term outcomes. |
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Authors:
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Claudio Baracchini; Marina Saladini; Renata Lorenzetti; Renzo Manara; Giuseppe Da Giau; Enzo Ballotta |
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Publication Detail:
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Type: Journal Article Date: 2011-11-21 |
Journal Detail:
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Title: Journal of vascular surgery Volume: 55 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-23 Completed Date: 2012-03-12 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 338-45 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Neurological Sciences, University of Padua, School of Medicine, Padova, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Carotid Stenosis / complications, diagnosis, mortality, surgery* Chi-Square Distribution Disease-Free Survival Electroencephalography Endarterectomy, Carotid* / adverse effects, mortality Female Hospitals, University Humans Ischemic Attack, Transient / etiology Italy / epidemiology Kaplan-Meier Estimate Male Odds Ratio Prospective Studies Recurrence Risk Assessment Risk Factors Sex Factors Stroke / etiology Survival Rate Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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