Analysis of Florida and New York state hospital discharges suggests that carotid stenting in symptomatic women is associated with significant increase in mortality and perioperative morbidity compared with carotid endarterectomy

Journal of Vascular Surgery
A G VouyoukaP L Faries

Abstract

Although large randomized studies have established the efficacy and safety of carotid endarterectomy (CEA) and, recently, carotid artery stenting (CAS), the under-representation of women in these trials leaves the comparison of risks to benefits of performing these procedures on women an open question. To address this issue, we reviewed the hospital outcomes and delineated patient characteristics predicting outcome in women undergoing carotid interventions using New York and Florida statewide hospital discharge databases. We analyzed in-hospital mortality, postoperative stroke, cardiac postoperative complications, and combined postoperative stoke and mortality in 20,613 CEA or CAS hospitalizations for the years 2007 to 2009. Univariate and multiple logistic regression analyses of variables were performed. CEA was performed in 16,576 asymptomatic and 1744 symptomatic women and CAS in 1943 asymptomatic and 350 symptomatic women. Compared with CAS, CEA rates, in asymptomatic vs symptomatic, were significantly lower for in-hospital mortality (0.3% vs 0.8% and 0.4% vs 3.4%), stroke (1.5% vs 2.6% and 3.5% vs 9.4%), and combined stroke/mortality (1.7% vs 3.1% and 3.8% vs 10.9%). In cohorts matched by propensity scores, the same trend ...Continue Reading

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Citations

Mar 8, 2013·Future Cardiology·Mehmet CilingirogluMark H Wholey
Aug 16, 2016·Advances in Surgery·Ali F AbuRahma, Albeir Y Mousa
Dec 19, 2013·Vascular and Endovascular Surgery·Nasim HedayatiWei Zhou
Jul 15, 2015·Journal of Cerebrovascular and Endovascular Neurosurgery·E-Wook JangKyung-Yul Lee
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Jun 7, 2020·Annals of Vascular Surgery·Susanna W L de GeusJeffrey J Siracuse
Mar 26, 2021·Frontiers in Surgery·Edoardo PasquiGiancarlo Palasciano
Oct 12, 2018·Journal of Vascular Surgery·Daiva NevidomskyteUNKNOWN Surgical Care and Outcomes Assessment Program (SCOAP) Collaborative

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