Carotid endarterectomy in women versus men: Patient characteristics and outcomes

Purpose: To examine and compare the results of carotid endarterectomy in women and men in a single-group experience. Methods: A review of a consecutive series of 426 carotid endarterectomy procedures performed over an 11-year period. Results: Women and men who underwent carotid endarterectomy were remarkably similar in nearly all characteristics except that women were less likely to have clinically overt coronary artery disease. Women were more likely than men to undergo patch closure of the carotid artery, but details of surgery and hospital stay were otherwise similar. A trend toward higher perioperative stroke risk in women was not significant, and late ipsilateral stroke risk was comparable in women and men. Women enjoyed a better late survival rate, presumably related to their lower prevalence of coronary artery disease. Conclusions: Women enjoyed similarly low risks of perioperative and late stroke and a better long-term survival rate when compared with men who underwent carotid endarterectomy. Further experience and longer follow-up in prospective randomized trials may provide more definitive information regarding the comparative efficacy of carotid endarterectomy in women and men, but our results suggest that absolute results are similar and excellent in both women and men.