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The Risk and Benefit of Endarterectomy in Women with symptomatic Internal Carotid Artery Disease

John J. Cranley Vascular Laboratory, Good Samaritan Hospital, Good Samaritan Outpatient Center, 6350 Glenway Avenue, Suite 208, Cincinnati. OH 45211; jlohr{at}lohrss.com

Kapil Simlote, MD

John J. Cranley Vascular Laboratory, Good Samaritan Hospital, Good Samaritan Outpatient Center, 6350 Glenway Avenue, Suite 208, Cincinnati. OH 45211

The authors conducted a study of data from the North American Symptonmatic Carotid Endarterectomy Trial and the ASA and Carotid Endarterectomy trial to compare the efficacy of carotid endarterectomy and medical therapy in women and men with symptomatic internal carotid artery stenosis. Women had a higher risk of death and perioperative risk of stroke and death compared with men. The 5-year absolute risk reduction in stroke was similar. In women who had 50% to 60% stenosis, CE was not beneficia' compared to men. Medically treated women hao a low risk for stroke. The conclusion was that women and men with more than 70% symptomatic stenosis had a similar long-term benefit from carotid endarterectomy but that women had higher perioperative risks.

Key Words: Carotid endarterectomy • gender differences • atheroscierotic disease

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