Carotid endarterectomy in women: Early and long-term results

Background. Although many randomized trials and other multicenter. studies have demonstrated the benefits of carotid endarterectomy (CEA) in selected symptomatic and asymptomatic patients, including women, there is a remarkab le lack of reports regarding the outcome of CEA with respect to sex. To ana lyze and compare the outcome of CEA in men and women in a single-group expe rience, reviewed a consecutive series of 619 CEAs performed in 539 patients , 371 men (423 CEAs) and 168 women (196 CEAs). Methods, Data collection was retrospective up to August 1, 1992 and prospec tive for all 405 patients treated thereafter. Results, Women were significantly less likely than men to have overt eviden ce of coronary artery disease (P < .001) and had a significantly higher inc idence of diabetes (P < .001). No perioperative death occurred in the femal e group, (P = NS), and no statistical difference was found in perioperative stroke risk incidence. Women had a significantly higher incidence of late occlusive events (P = .01), which were all asymptomatic. No late stroke occ urred in the female group (P = NS). Life-fable cumulative survival rates at 1, 3, 5, and 7 years were 99.3 %, 90.5 %, 85.9 %, and 82.3 %, respectively , in women, and 98.9%, 91.9%, 85.2%, and 79.6% in men (log-rank P =.8). Conclusions. These findings show that Perioperative stroke risk and mortali ty rates, as well as late stroke-free ee, mortality, and recurrence rates, in It,patients undergoing CEA, are comparable in men and women. Further, la rger comparative studies are necessary to provide more information on the b enefit and durability of CEA in asymptomatic patients, but the results of t his study suggest that the early and late outcomes are excellent and compar able In symptomatic and asymptomatic men and women.