The excess of strokes in female patients after CEA is due to their increased thromboembolic potential--analysis of 775 cases.
BACKGROUND
Women suffer an excess of complications following arterial surgery, including an increased stroke risk following CEA. In order to investigate this further we studied men and women's thromboembolic potential following CEA.


METHODS
Analysis of prospectively collected data on 775 consecutive CEAs performed between October 1995 and October 2001, to identify the number of microembolic events detected following CEA.


RESULTS
Overall women had a 2.2 fold increase in the number of postoperative emboli detected (95% CI 1.2-3.3). Of those patients with significant numbers of postoperative emboli (>25), 68% were female against 22% for men (p=0.009). In order to prevent progression onto postoperative thrombotic stroke 9.7% of women were treated with intravenous Dextran-40 therapy, as opposed to only 2.7% of men (p=0.013). There were no significant differences between men and women's preoperative risk factors and/or factors relating to their operation.


CONCLUSIONS
It is possible that women's excess of postoperative complications following arterial surgery is related to their apparent increased thromboembolic potential following acute arterial injury.
Hayes
P D
PD
Department of Surgery, University of Leicester, Leicester, UK.
Payne
D A
DA
Evans
N J
NJ
Thompson
M M
MM
London
N J L
NJ
Bell
P R F
PR
Naylor
A R
AR
D000368:Aged; D016893:Carotid Stenosis / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D015996:Survival Rate; D016896:Treatment Outcome