title: Gender differences in patients with carotid stenosis.
abstract: This overview analyses gender differences in prevalence, epidemiology, risk factors and therapy in patients with carotid stenosis in a systematic review. Ischemic stroke is a leading cause of death in Western society, where about 20% of cases are triggered by a carotid stenosis or occlusion, which occurs more frequently in men than in women. The stroke-protective effect of carotid endarterectomy is greater in men. Men have lower peri-procedural stroke and death rates. Particularly men with carotid stenosis and a life expectancy of at least 5 years benefit from surgical treatment. Also, the recurrence rate of ipsilateral stroke 5 years after initial surgery is lower in men than in women. It is not yet fully clarified whether there are significant gender differences regarding the outcome after endovascular versus surgical treatment. Gender differences in the outcome of carotid artery repair may be caused by biological, anatomical (smaller vessel diameter in women) or hormonal differences as well as a protracted development of atherosclerotic changes in women and different plaque morphology. Moreover, women are on average older at the time of surgery and their surgical treatment is often delayed. To reduce the risk of stroke and to improve treatment outcome especially for women, further research on gender differences and their causes is mandatory and promising.
authors.affiliation: University Heart Center, Hamburg, Germany.
authors.forename: Konstanze
authors.initials: K
authors.lastname: Stoberock
authors.affiliation: University Heart Center, Hamburg, Germany.
authors.forename: Eike Sebastian
authors.initials: ES
authors.lastname: Debus
authors.affiliation: University Heart Center, Hamburg, Germany.
authors.forename: Gülsen
authors.initials: G
authors.lastname: Atlihan
authors.affiliation: University Heart Center, Hamburg, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Daum
authors.affiliation: University Heart Center, Hamburg, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Larena-Avellaneda
authors.affiliation: University Heart Center, Leipzig, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Eifert
authors.affiliation: University Heart Center, Hamburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Wipper
mesh_terms: D017130:Angioplasty / Q000295:instrumentation; D058070:Asymptomatic Diseases; D016893:Carotid Stenosis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016894:Endarterectomy, Carotid; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D015995:Prevalence; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carotid stenosis; carotid artery stenting; carotid endarterectomy; gender; prevalence; sex