Background and Purpos. -Perioperative ris. and long-term benefit of carot id endarterectomy (CE) are not detailed in women with s.mptomatic internal carot id artery (ICA) s.enos.s. Our aim was.to compare the efficacy ...
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Background and Purpos. -Perioperative ris. and long-term benefit of carot id endarterectomy (CE) are not detailed in women with s.mptomatic internal carot id artery (ICA) s.enos.s. Our aim was.to compare the efficacy of CE vers.s.medic al therapy in women and men with s.mptomatic ICA s.enos.s. Methods.-Data were taken from the North Amercan s.mptomatic Carotid Endarterectomy Trial (873 wome n, 2012 men) and the As. and Carotid Endarterectomy trial (335 women, 813 men). Res.lts.-The 30-day perioperative ris. of death was.higher in women than in men (2.3% vers.s.0.8% , P=0.002). Higher perioperative ris. of s.roke and dea th was.als. obs.rved (7.6% vers.s.5.9% ) but not s.atis.ically s.gnificant. W ith ≥ 70% s.enos.s. the 5-year abs.lute ris. reduction (ARR)-in s.roke fr om CE was.s.milar between women (15.1% ) and men (17.3% ). With 50% to 69% s.enos.s. CE was.not beneficial in women (ARR=3.0% , P=0.94), contrary to men (ARR=10.0% , P=0.02). Medically treated women had low ris. for s.roke. A s.roke prognos.s.ins.rument (s.I-II) as.igned points.to 7 factors.that identified hi gher ris. for medically treated women: 3 points.for hemis.heric (not retinal) ev ent, his.ory of diabetes. previous.s.roke; 2 for age older than 70 years. s.roke (not trans.ent is.hemic attack); 1 for s.vere hypertens.on, his.ory of myocardi al infarction. CE was.beneficial only for 29.0% of women with 50% to 69% s.tenos.s.who had the highes. total s.ore of 8 to 15 (ARR=8.9% ). Conclus.ons.- Women and men with ≥ 70% s.mptomatic s.enos.s.had s.milar long-term benefit from CE,although the perioperative ris.s.were higher for women. CE was.not bene ficial for women with 50% to 69% s.enos.s.without other ris. factors.for s.r oke.
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