• Vascular Annual Meeting^®
• Registration
• Hotel Reservations
• Schedule-at-a-Glance
• Program-in-Detail
• Wednesday, June 9 - Postgraduate Courses Day
• Thursday, June 10
• Friday, June 11
• Saturday, June 12
• Sunday, June 13
• International Attendee Information
• General Information
• New in 2010
• Call for Abstracts
• Speaker Information
• Exhibitor Information
• Alumni Association Information
• Future Meeting Dates
• 2009 Meeting Information
• Contact Us

Home > Vascular Annual Meeting^® > SS32. Carotid Endarterectomy in Female Patients...

SS32. Carotid Endarterectomy in Female Patients: Subsets of Patients at Higher Surgical Risk

Walter Dorigo1, John Marek2, Raffaele Pulli1, Alessandro Alessi Innocenti1, Giovanni Pratesi3, Carlo Pratesi1
1University of Florence, florence, Italy; 2University of New Mexico, Albuquerque, NM; 3University of Tor Vergata ,Rome, Italy

OBJECTIVES: To evaluate early and late results of carotid endarterectomy (CEA) in female patients in a large single center experience.

METHODS: Over a 12 year period ending in December 2007, 4,009 consecutive CEAs were performed at our institution. All patients were prospectively enrolled in a dedicated database containing pre, intra and postoperative parameters. Patients were female in 1200 cases (Group 1) and male in the remaining 2809 (Group 2). Early results in terms of intraoperative neurological events and 30-day stroke and death rates were analyzed and compared. Follow-up results were analyzed with Kaplan Meyer curves and compared with log-rank test.

RESULTS: Patients of group 1 were more likely to have hyperlipemia, diabetes and hypertension; patients of group 2 were more likely to be smokers and to have concomitant coronary artery disease (CAD) and peripheral arterial disease (PAD). There were no differences in terms of clinical status or degree of stenosis. Patients of group 2 had a significantly higher percentage of contralateral carotid artery occlusion than patients in group 1 (6.9% and 3.9%, respectively). There were no-differences in terms of intraoperative neurological events (0.4% and 0.9%, respectively); and 30-day stroke and death rates were similar in the two groups (1.2% for both groups). Univariate analysis demonstrated the presence of CAD, PAD, diabetes and contralateral carotid artery occlusion to significantly affect 30-day stroke and death rate in female patients. At multivariate analysis, only diabetes (OR 3.6, 95% CI 0.1-0.9) and contralateral occlusion (OR 7.4, 95% CI 0.03-05) were independently associated with an increased periperative risk of stroke and death. Median duration of follow-up was 27 months (range 1-144). There were no differences between the two groups in terms of survival, freedom from ipsilateral stroke, freedom from any neurological symptom and freedom from severe (>70%) restenosis.

CONCLUSIONS: Female sex per se does not represent an adjunctive risk factor during CEA, with early and long term results comparable to those obtained in male patients. However, there are several subgroups of female patients at higher surgical risk, requiring appropriate selection and careful intra and postoperative management.

AUTHOR DISCLOSURES: W. Dorigo, None; J. Marek, None; R. Pulli, None; A. Alessi Innocenti, None; G. Pratesi, None; C. Pratesi, None.