Safety of Carotid Revascularization during the Acute Period of Neurological Symptom Onset in Women.
Ann Vasc Surg
; 44: 343-352, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-28479455
ABSTRACT
BACKGROUND:
Benefit from carotid revascularization is supposed to be lower in women due to increased periprocedural risks. The aim of this study was to investigate the risk of stroke/death after carotid intervention in women treated within 15 days from last neurological event.METHODS:
Data from 282 consecutive patients treated during 2009-2015 by carotid endarterectomy or carotid stenting within 15 days from neurological symptoms were analyzed by sex and stratified according to treatment delay toward symptoms onset.RESULTS:
Eighty women (28.4%) underwent carotid stenosis correction in 37 treatment was performed within 7 days from symptoms (in 12 within 48 hr); the remaining underwent carotid disease correction between day 8 and day 15 after the index event. Baseline comorbidity profile, presenting symptoms (stroke, transient ischemic attack, and recurrent symptoms) and treatment delay were comparable between sexes. The 30-day stroke/death rate was 2.5% in women (2/80) and 3.5% (7/202) in men (P = 1.00). There was no 30-day death or cerebral hemorrhage in women and in patients treated within the first 48 hours. In adjusted analyses, female sex was not associated with increased stroke/death risk. At 4 years, for women and men survival was 93.9% vs. 79.2% (P = 0.047) and freedom from stroke 92.6% vs. 92.2% (P = 0.76).CONCLUSIONS:
Women with symptomatic carotid stenosis may benefit as men from intervention when performed within the acute (15 days) or hyperacute (48 hr) period after neurological event. Thirty-day stroke/death rate in this experience is lower or comparable to men's and treatment appears to be effective in preventing new strokes at midterm.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Endarterectomia das Carótidas
/
Estenose das Carótidas
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Angioplastia
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Acidente Vascular Cerebral
/
Tempo para o Tratamento
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article