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 PS58. Gender Differences in Presentation of Patients Undergoing CEA and CAS in VSGNE

​Rodney P. Bensley, Ruby C. Lo, Rob Hurks, Elliot L. Chaikof, Allen D. Hamdan, Mark C. Wyers, Marc L. Schermerhorn
Surgery, Beth Israel Deaconess Medical Center, Boston, MA.

OBJECTIVES: Gender differences in the presentation of patients undergoing CEA and CAS are not well studied. Women have been shown to benefit less from revascularization for asymptomatic carotid disease. Therefore, we analyzed a regional database to identify gender differences in patient presentation for CEA and CAS.

METHODS: We used the Vascular Study Group of New England database to identify all patients undergoing CEA or CAS. We analyzed demographics, comorbidities, symptom status, and outcomes in men and women.

RESULTS: We identified 9,376 patients: 8,852 CEA and 524 CAS. Men comprised 60% of the study group. Mean age was similar at 69 years. Women were more likely to be current smokers with COPD and had less heart disease and prior CABG/PCI. For CEA women were more likely to be asymptomatic than men (70% vs. 65% p<.001). Of asymptomatic patients, a similar proportion had carotid stenoses >80% (74.3% in women vs. 72.5% in men p=.11). Both symptomatic and asymptomatic women had similar rates of any stroke or death compared to men (symptomatic 2.2% vs. 2.1% p=.81 and asymptomatic 0.9% vs. 0.9% p=.76).

CONCLUSIONS: Despite prior data suggesting women benefit less from carotid revascularization for asymptomatic carotid disease, 70% of revascularizations were performed in asymptomatic women. Stroke and death rates compare favorably to randomized controlled trials for both symptomatic and asymptomatic patients.

AUTHOR DISCLOSURES: R. P. Bensley, Nothing to disclose; E. L. Chaikof, Nothing to disclose; A. D. Hamdan, Nothing to disclose; R. Hurks, Nothing to disclose; R. C. Lo, Nothing to disclose; M. L. Schermerhorn,  Medtronic, Consulting fees or other remuneration (payment), Boston Scientific, Consulting fees or other remuneration (payment), Endologix, Consulting fees or other remuneration (payment); M. C. Wyers, Nothing to disclose.

Demographics, comorbidities, and symptom status in patients undergoing CEA and CAS

Men
Women
p-Value
Age (years)
69.4
69.6
0.27
Current smoker
28.4%
33.2%
<.001
COPD
21.6%
25.2%
<.001
HTN
87.3%
89.1%
<.01
Diabetes
31.2%
31.8%
0.54
Heart disease
37.6%
27.8%
<.001
Prior CABG/PCI
37.1%
24.5%
<.001
Dialysis
0.5%
0.5%
0.81
Symptomatic
35.1%
30.4%
<.001

 

Posted April 2012

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