Abstract 1967: Acute and Long-term Follow-up of Carotid Stenting in Female and Male Patients with Carotid Stenosis: Does Gender have an Effect on the Result of Carotid Stenting?
Background: Mortality and morbidity of many interventional procedures is higher in women than in men. We compared the acute and long-term results of carotid stenting of female patients with the results of male patients.
Patients: Results of carotid stenting of 218 stenoses in 203 female patients were compared to 474 lesions in 441 male patients. There were no significant differences beside gender regarding base line characteristics.
Methods: We used embolic protection devices in 89.5% and 86.3% respectively. 99.1% and 98.8% were treated with stent implantation. Follow-up investigations included a neurolog. examination before discharge, after 1 month and whenever an event occurred. Carotid duplex scan was performed after 1 and 6 months. Thereafter, a questionnaire was sent every year.
Results: The procedure was techn. successful in all lesions. During or within 30 days of the intervention 1 female patient developed a minor stroke and 9 a major stroke. So the stroke/death rate at 30 days was 5.1%. Follow-up ranged from 1 month to 7 years (554 patient years). During follow-up 1 female patient developed a major stroke and 13 died of non cerebrovascular reason. The annual rate of ipsilat. stroke/cerebrovascular death was 1.99%. The procedure was techn. successful in 470/474 lesions. During or within 30 days of the procedure the following complications occurred: Minor stroke in 1 male patient, major stroke in 4, 4 non-cerebral deaths and 1 cerebral death. The death/stroke rate at 30 days was 1.5%. Follow-up ranged from 1 month to 10.8 years (1317 patient years). During follow-up occurred: Cerebrovascular death in 3, ipsilat. major stroke in11, ipsilat. minor stroke in 1, non-cerebrovascular death in 43 male patients. The annual rate of ipsilat. stroke/cerebrovascular death was 1.8%. The difference between both groups in the death/stroke rate at 30 days was significant, but not the difference in the annual rate of ipsilateral stroke/crebrovascular death during follow-up.
Conclusion: Carotid stenting is a successful technique to prevent stroke for both gender. Complications for female patients occur mostly within 30 days. The periprocedural risk is higher for female patients but neurological events and cerebrovascular death throughout long-term follow up are rare.