Carotid angioplasty and stenting is safe in women.
BACKGROUND
Results of randomized controlled trials have shown that carotid endarterectomy poses greater perioperative risks to women than to men. There are limited studies regarding sex differences in carotid angioplasty and stenting.


OBJECTIVE
To compare male and female patients undergoing carotid stenting with regard to their intraprocedural complications and 30-day outcome.


METHODS
We reviewed patients who underwent carotid stenting between 1997 and 2007 at our tertiary centre. Distal protection devices were used in all patients after 1999. Demographics, risk factors, intraprocedural complications, and 30-day outcomes were compared between female and male patients.


RESULTS
Among 243 patients who underwent 255 procedures, 67 were women (27.6%). The mean (SD) age of the female patients was 72.2 ± 8.4 years and that of the male patients was 72.0 ± 9.6 years (P = .83). The majority of patients had symptomatic carotid artery disease; 11 women (16.4%) and 30 men (16.0%) were asymptomatic. The following intraprocedural complications were noticed in female vs male patients: asymptomatic carotid and/or iliac dissections 7.5% vs 0% (P = .001), minor stroke 0% vs 1.1% (P = 1.00), major stroke 0% vs 0.5% (P = 1.00), and cardiac dysrhythmias 3% vs 2.7% (P = 1.00). At 30 days, the outcomes in women vs men were as follows: mortality 3.0% vs 3.2% (P = 1.00), major stroke 3.0% vs 2.1 % (P = .66), and minor stroke 3.0% vs 3.2% (P = 1.00).


CONCLUSIONS
Although minor asymptomatic intraprocedural dissections were more common in women, we did not find any impact of sex on the 30-day outcome. We concluded that carotid stenting can be performed as safely in women as in men.
Shobha
Nandavar
N
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Almekhlafi
Mohammed A
MA
Pandya
Anjali
A
Couillard
Philippe L
PL
Morrish
William F
WF
Wong
John H
JH
Hill
Michael D
MD
D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017023:Coronary Angiography; D016894:Endarterectomy, Carotid / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome