Document Detail


Gender-based outcomes after eversion carotid endarterectomy from 1998 to 2009.
MedLine Citation:
PMID:  22104344     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Claudio Baracchini; Marina Saladini; Renata Lorenzetti; Renzo Manara; Giuseppe Da Giau; Enzo Ballotta
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Publication Detail:
Type:  Journal Article     Date:  2011-11-21
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-23     Completed Date:  2012-03-12     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-45     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Neurological Sciences, University of Padua, School of Medicine, Padova, Italy.
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MeSH Terms
Descriptor/Qualifier:
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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