title: Carotid artery stenting in clinical practice: does sex matter? Results from the carotid artery stenting registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK).
abstract: BACKGROUND
  Carotid artery stenting (CAS) is increasingly used for treatment of severe carotid artery stenosis, but only few procedural risk factors for complications of CAS are clearly defined yet. A possible impact of the patient's gender on the outcome of patients undergoing CAS has not been investigated properly and only little information about this topic is available so far.
  
  
  METHODS
  We analysed data of the German prospective, multicenter CAS Registry of the Arbeitsgemeinschaft leitende kardiologische Krankenhausärzte.
  
  
  RESULTS
  From July 1996 to May 2009 5130 patients underwent CAS at 35 German hospitals and were enrolled into the prospective ALKK CAS Registry. Therefrom 1443 (28.1%) patients were female. There was no significant time-related difference in the proportion of women undergoing CAS over the years. Women undergoing CAS were significantly older than men (73 years vs. 70 years, p < 0.01) and had a longer in hospital stay in comparison to men (p < 0.01). The majority of patients treated with CAS was between 60 and 80 years of age (∼73%). No significant differences between women and men could be found regarding in-hospital events like death (0.5% vs. 0.5%, p = 0.99), major or minor stroke (1.7% vs. 1.6%, p = 0.97; 1.0% vs. 1.6%, p = 0.12), TIA (2.8% vs. 2.6%, p = 0.64), amaurosis fugax (0.3% vs. 0.5%, p = 0.25) , intracranial bleeding (0.5% vs. 0.3%, p = 0.43), myocardial infarction (0.1% vs. 0.0%, p = 0.48) or all non-fatal strokes and all death (3.0% vs. 3.4%, p = 0.47). 30 day event rates did not show gender related differences in the combined endpoint of the outcome of patients undergoing CAS, as well (♀ n = 31/882 [3.5%] vs. ♂ n = 109/2273 [4.8%], p = 0.12).
  
  
  CONCLUSIONS
  Our results do not suggest any gender-related differences in success rates and complications in CAS. In clinical practice approximately 30% of patients treated with CAS are women. The institutions and people who participated in the ALKK CAS Registry are listed in Zahn et al.16 The authors have no funding, financial relationships, or conflicts of interest to disclose.
authors.affiliation: Herzzentrum, Kardiologie, Ludwigshafen, Städtisches Klinikum, Germany. wernern@klilu.de
authors.forename: Nicolas
authors.initials: N
authors.lastname: Werner
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Bernd
authors.initials: B
authors.lastname: Mark
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.forename: Karl Eugen
authors.initials: KE
authors.lastname: Hauptmann
authors.forename: Jens
authors.initials: J
authors.lastname: Jung
authors.forename: Ellen
authors.initials: E
authors.lastname: Hoffmann
authors.forename: Albrecht
authors.initials: A
authors.lastname: Elsässer
authors.forename: Thomas
authors.initials: T
authors.lastname: Fürste
authors.forename: Matthias
authors.initials: M
authors.lastname: Leschke
authors.forename: Harald
authors.initials: H
authors.lastname: Mudra
authors.forename: Ralf
authors.initials: R
authors.lastname: Zahn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020757:Amaurosis Fugax / Q000209:etiology; D000800:Angioplasty, Balloon / Q000009:adverse effects; D016893:Carotid Stenosis / Q000150:complications / Q000628:therapy*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome