title: Austrian national carotid intervention numbers prompt improvement in secondary stroke prevention.
abstract: BACKGROUND
  As recent data suggest a variable benefit of carotid endarterectomy (CEA) or stenting (CAS), a careful selection of patients is mandatory for efficient stroke prevention. This retrospective study analyzed carotid intervention rates from 1999-2008 in Austria. The aim was to assess whether interventions for carotid stenosis were performed with respect to epidemiological trends and published data taking into account intervention type, age and gender.
  
  
  METHODS
  Intervention numbers for internal carotid artery (ICA)-stenosis from a 10 years period (1999 to 2008) were retrieved from the national Austrian registry for hospital funding. Patients were grouped by gender, age (0-64, 65-74, older than 75 years) and intervention type.
  
  
  RESULTS
  CEA rates amounted to 32.2±1.4 per 100000 persons annually (female: 22.1±0.7, male: 43.0±2.3). Each year 9.1 CAS±1.6 per 100000 Austrians were performed (female: 9.3±1.8, male 8.9±1.7). CAS numbers increased (P<0.05), whereas CEA numbers stagnated, especially in older age groups. Women were more likely to undergo CAS than CEA compared to men.
  
  
  CONCLUSIONS
  Relative intervention rates for carotid stenosis have rather stagnated, although stroke incidence increases continuously in an overaging society. Despite controversial data, CAS rates have been rising constantly in elderly women. Secondary stroke prevention in Austria can be improved by a careful selection of future patients, especially with regard to female gender and type of intervention.
authors.affiliation: Department of Vascular and Endovascular Surgery, Wilhelminenspital, Vienna, Montleartstrasse 37, Austria. nduschek@me.com
authors.forename: N
authors.initials: N
authors.lastname: Duschek
authors.forename: T
authors.initials: T
authors.lastname: Waldhör
authors.forename: J
authors.initials: J
authors.lastname: Falkensammer
authors.forename: E
authors.initials: E
authors.lastname: Skrinjar
authors.forename: S
authors.initials: S
authors.lastname: Koulas
authors.forename: G S
authors.initials: GS
authors.lastname: Bayer
authors.forename: A
authors.initials: A
authors.lastname: Assadian
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data*; D001317:Austria / Q000453:epidemiology; D016893:Carotid Stenosis / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods / Q000706:statistics & numerical data*; D012737:Sex Factors; D015607:Stents; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult