Abstract W P68: Safety of Carotid Revascularization During the Acute Period of Neurological Symptom Onset in Female Patients
Background: Benefit from carotid revascularization might be lower in female patients due to increased periprocedural stroke/death risks exposure.
Aim of this study was to define the 30-day risks of stroke/death after carotid endarterectomy (CEA) and carotid stenting (CAS) in symptomatic female patients treated within 15 days from last neurological event.
Methods: Data of 227 consecutive patients treated during 2009-2014 by CEA or CAS within 15 days from neurological symptoms were analyzed by sex and stratified according to the delay of symptom onset.
Results: There were sixty-six (29.1%) females (mean age 74.6y): 32 were treated within the first 7 days and 13 within 48hours from symptom onset. Stroke was the index event in 33 (50%), while in 17 (25.8%) recurrent TIA were recorded in the last 2 weeks before intervention. Twenty-six procedures were performed by CAS with similar rates in males and females. Baseline comorbidity profile, presenting symptoms (stroke, TIA, recurrent TIA) and timing of treatment were comparable between sexes, but there was a tendency for higher proportion of preoperative cerebral lesions in females compared to males (60.7% vs 42.8%; P=.022).
The 30-day stroke and death rate was 3.0% in females (2/66) and 2.5% (4/161) in males (Odds ratio 1.27; 95% Confidence Interval, 0.27-7.12; P=.99).There were no 30-day deaths or cerebral hemorrhage in the female group. No 30-day stroke or death occurred in patients undergoing the procedure within the first 48 hours. In adjusted analyses female sex was not associated with increased stroke/death risk. At 4 years survival rates were 98% in female and 87.6% in male patients (P=.11); freedom from stroke rates were 90.1% vs. 95.5% (P=.19) in females and males, respectively.
Conclusions: Female patients with symptomatic carotid stenosis may benefit from carotid intervention when performed within the acute (15 days) or hyperacute (48 hours) period after neurologic ischemic event. 30-day stroke and death rates were below or comparable to those of previous randomized trials and treatment was effective in preventing new strokes at mid-term.
Author Disclosures: P. De Rango: None. M. Lenti: None. E. Cieri: None. L. Farchioni: None. G. Parlani: None. B. Fiorucci: None. V. Caso: None.
- © 2015 by American Heart Association, Inc.