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Titolo:
Carotid endarterectomy in female patients: Are the concerns of the Asymptomatic Carotid Atherosclerosis Study valid?
Autore:
Rockman, CB; Castillo, J; Adelman, MA; Jacobowitz, GR; Gagne, PJ; Lamparello, PJ; Landis, R; Riles, TS;
Indirizzi:
NYU, Med Ctr, Div Vasc Surg, New York, NY 10016 USA NYU New York NY USA 10016 Med Ctr, Div Vasc Surg, New York, NY 10016 USA
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 2, volume: 33, anno: 2001,
pagine: 236 - 240
SICI:
0741-5214(200102)33:2<236:CEIFPA>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
ARTERY STENOSIS; RISK-FACTORS; GENDER; STROKE; WOMEN; SEX;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Rockman, CB NYU, Med Ctr, Div Vasc Surg, 530 1st AVe,Suite 6F, New York, NY 10016 USA NYU 530 1st AVe,Suite 6F New York NY USA 10016 k, NY 10016 USA
Citazione:
C.B. Rockman et al., "Carotid endarterectomy in female patients: Are the concerns of the Asymptomatic Carotid Atherosclerosis Study valid?", J VASC SURG, 33(2), 2001, pp. 236-240

Abstract

Objectives: Although the results of the Asymptomatic Carotid Atherosclerosis Study clearly demonstrated the benefit of surgical over medical management of severe carotid artery stenosis, the results for women in particular were less certain. This was to some extent because of the higher perioperative complication rate observed in the 281 women (3.6% vs 1.7% in men). The objective of this study was to review a large experience with carotid endarterectomy in female patients and to determine whether the perioperative results differed from those of male patients. Methods: A review was conducted of a prospectively compiled database on all carotid endarterectomies performed between 1982 and 1997. Operations performed in 991 female patients were compared with those performed in 1485 male patients. Results: Female patients had a significantly lower incidence of diabetes, coronary artery disease, and contralateral carotid artery occlusion than did male patients. Female patients had a significantly higher incidence of hypertension. There were no significant differences in the age, smoking history, anesthetic route, shunt use, or clamp tolerance between the two groups. Of 991 female patients, 659 (66.5%) had preoperative symptoms, whereas 332(33.5%) cases were performed for asymptomatic stenosis. Among 1485 male patients, 1041 (70.1%) had symptoms, and 444 (29.9%) were symptom free beforesurgery. There were no significant differences noted in the perioperative stroke rates between men and women overall (2.3% vs 2.4%, P = .92), or whendivided into symptomatic (2.5% vs 3.0%, P = .52) and asymptomatic (2.0% vs1.2%, P = .55) cases. Conclusions: Carotid endarterectomy can be performed with equally low perioperative stroke rates in men and women in both symptomatic and asymptomatic cases. In this series, symptom-free female patients had the lowest overall stroke rate. The concerns of the Asymptomatic Carotid Atherosclerosis Study regarding the benefit of carotid endarterectomy in female patients should therefore not prevent clinicians from recommending and performing carotidendarterectomy in appropriately selected symptom-free female patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 12:30:06