Carotid Stenting Riskier Than Surgery in Women

Women who undergo stenting at higher risk for stroke; increased risk not seen in men

THURSDAY, May 12 (HealthDay News) -- Women who undergo carotid artery stenting may be at higher risk for stroke than those who undergo endarterectomy, but little difference is seen between men who undergo one of the two blockage clearing procedures, according to research published online May 6 in The Lancet Neurology.

Virginia J. Howard, Ph.D., of the University of Alabama at Birmingham, and colleagues randomly assigned 2,502 asymptomatic patients with recent history of stroke or transient ischemic attack -- 872 of whom were women -- to carotid endarterectomy or carotid artery stenting.

The researchers found that, in the 30 days post-procedure, men had similar rates of stroke, heart attack, or death whether they had stenting or surgery (4.3 versus 4.9 percent), while those outcomes occurred in 6.8 percent of women who had stenting and 3.8 percent of women who had surgery. The sex difference was due mostly to a significantly higher likelihood of stroke in women after stenting compared with surgery (5.5 versus 2.2 percent), though the post-surgery risk of stroke did not significantly differ by procedure in men.

"Periprocedural risk of events seems to be higher in women who have carotid artery stenting than those who have carotid endarterectomy; whereas, there is little difference in men. Additional data are needed to confirm whether this differential risk should be taken into account in decisions for treatment of carotid disease in women," the authors write.

The study was supported in part by Abbott Vascular Solutions.

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