• Vascular Annual Meeting
• General Information
• Exhibitor Information
• Future Meeting Dates
• Past Meeting Information
• Contact Us

Home > Vascular Annual Meeting > pvss6_carotid_goldstein

PVSS6. Carotid Artery Stenting in Women Is a Safe Procedure with Equivocal Outcomes Compared to Men

Lee J. Goldstein, Soo J. Rhee, Elliot B. Sambol, Habib Khan, James F. McKinsey, K. Craig Kent, Peter L. Fairies, Ageliki G. Vouyouka.
New York Presbyterian Hospital, New York, N.Y.

OBJECTIVES:  Historically, large randomized controlled studies have indicated an increased peri-operative risk for women undergoing CEA. The outcomes of carotid stenting in women as compared to men have not been adequately investigated. We sought to determine the results in women treated by carotid stenting (CAS).

METHODS: 80 carotid stents were performed on 77 women between 2003-2006. Procedures, complications, demographics, comorbidities, and follow-up data were entered into a prospective database for review. Arterial anatomic characteristics evaluated using angiographic images were common carotid/internal carotid lesion length ratio, common carotid /internal carotid diameter, index lesion length, and index lesion calcification. Outcomes compared included post-operative length of stay, need for post-operative pressors, stroke, myocardial infarction and death.

RESULTS: Between 2003 and 2006, 194 patients underwent 201 procedures. 110 images were available for retrospective review. Cerebral protection devices were used in 192 cases; self-expanding stents were placed in all. A total of 80 percutaneous interventions performed in 77 women were compared with 121 interventions in 116 men. Mean age in women was 72.6 yrs, in men was 72.7 (p=0.91); 32.5% of women had symptomatic disease and 37.5% had bilateral disease compared to 27.3% and 33.0% of men, (p=0.47, p=0.66), respectively. Co-morbidities in females including HTN (96.3%), hypercholesterolemia (72.5%), and CAD (53.2%) were not statistically different from males (87.8%, 68.7%, 64.2%, respectively). There were no significant differences seen in anatomic arterial characteristics. There were no significant differences seen in overall 30- day peri-procedural stroke rate (1.25% in women and 4.2% in men, p=0.40), death rate (0% vs. 0.9%, p=1), cardiac events (3.6% vs. 0.9%, p=0.31), or post-operative need for pressors (23.8% vs. 19.1%, p=0.55).

CONCLUSIONS: Despite previous concerns over adverse outcomes in women undergoing carotid endarterectomy, our data shows carotid stenting to be a safe modality in women with equivalent outcomes when compared to men. Although large prospective trials are necessary to validate our experience, women should be favorably considered for carotid stenting.