Sirignano Pasqualino, Margheritini Costanza, Mansour Wassim, Aloisi Francesco, Setacci Carlo, Speziale Francesco, Stabile Eugenio, Taurino Maurizio
Vascular and Endovascular Surgery Unit, Sant'Andrea Hospital of Rome, Department of General and Specialistic Surgery, "Sapienza" University of Rome, 00189 Rome, Italy.
Vascular and Endovascular Surgery Unit, Sant'Andrea Hospital of Rome, Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
J Pers Med. 2024 Aug 5;14(8):830. doi: 10.3390/jpm14080830.
Reporting gender-related outcomes for symptomatic carotid lesion revascularization after both endarterectomy (CEA) and carotid artery stenting (CAS) procedures in an unselected group of patients treated by Italian Vascular Specialists.
A retrospective study was conducted on patients presenting with recently symptomatic carotid stenosis treated by CAS and by CEA. The primary endpoint was the 30 days any stroke occurrence rate; secondary endpoints were technical success, occurrence of transient ischemic attack (TIA), acute myocardial infarction (AMI) and death. Demographic, clinical and procedural data were all noted in order to identify the outcome's determining factor.
A total of 265 patients (193 males and 72 females) were enrolled, and of these 134 (50.5%) underwent CEA and 131 CAS (49.5%). At 30 days, the overall new stroke rate was 3.4% (one fatal), and no TIA, AMI or deaths were observed. Among strokes, seven major and two minor strokes were reported, with six after CEA and three after CAS ( = 0.32; OR: 2; CI95%: 0.48-8.17). The timing of revascularization has been found to be slightly associated with new stroke occurrence: seven out nine strokes were observed in patients treated within 14 days from symptom onset (5.5% vs. 1.4%; = 0.08, OR: 3.8, CI95%: 0.77-18.56). Lastly, female patients presented a significantly higher risk of post-operative stroke compared to male patients: 6.9% vs. 2.1% (: 0.05; OR: 3.52; CI95%: 0.91-13.52).
Our experience seems to suggest that both CEA and CAS provide safe and effective results in treating patients presenting with symptomatic carotid stenosis. Regardless of the type of revascularization, female sex is an independent risk factor for stroke recurrence after treatment.
报告意大利血管专科医生治疗的一组未经挑选的患者在接受颈动脉内膜切除术（CEA）和颈动脉支架置入术（CAS）后，有症状颈动脉病变血运重建的性别相关结果。
对接受CAS和CEA治疗的近期有症状颈动脉狭窄患者进行回顾性研究。主要终点是30天内任何卒中发生率；次要终点是技术成功率、短暂性脑缺血发作（TIA）、急性心肌梗死（AMI）和死亡的发生率。记录人口统计学、临床和手术数据，以确定结果的决定因素。
共纳入265例患者（193例男性和72例女性），其中134例（50.5%）接受了CEA，131例接受了CAS（49.5%）。30天时，总体新发卒中率为3.4%（1例致命），未观察到TIA、AMI或死亡。在卒中患者中，报告了7例大卒中及2例小卒中，CEA后6例，CAS后3例（P = 0.32；OR：2；95%CI：0.48 - 8.17）。已发现血运重建时机与新发卒中发生略有相关：9例卒中中有7例在症状发作后14天内接受治疗的患者中观察到（5.5%对1.4%；P = 0.08，OR：3.8，95%CI：0.77 - 18.56）。最后，女性患者术后卒中风险显著高于男性患者：6.9%对2.1%（P：0.05；OR：3.52；95%CI：0.91 - 13.52）。
我们的经验似乎表明，CEA和CAS在治疗有症状颈动脉狭窄患者方面均提供了安全有效的结果。无论血运重建类型如何，女性是治疗后卒中复发的独立危险因素。
