Title : The impact of gender on carotid revascularization outcomes: A comprehensive review
Abstract:
Background: Carotid revascularization procedures, including carotid endarterectomy (CEA) and carotid artery stenting (CAS) both transvervical and transfemoral, are commonly performed to reduce stroke risk in patients with symptomatic or asymptomatic carotid stenosis. Despite their widespread use, evidence regarding gender differences in clinical outcomes following these interventions remains inconsistent. Understanding these differences is crucial for improving individualized patient care and optimizing treatment strategies.
Objective: This literature review aims to synthesize and analyze existing studies on gender differences in outcomes following carotid revascularization, including perioperative complications, stroke prevention, restenosis rates, and long-term survival.
Methods: A comprehensive review of studies published between 2000 and 2023 was conducted using major medical databases such as PubMed, Scopus, and Cochrane. Studies assessing gender-based differences in perioperative morbidity and mortality, stroke recurrence, long-term survival, and procedural complications following CEA or CAS were included. Data were analyzed for trends in gender disparities across different clinical outcomes.
Results: The review revealed that female patients tend to experience higher rates of perioperative complications, including wound infections, myocardial infarction, and postoperative hemorrhage, compared to males. However, long-term stroke prevention outcomes were generally similar between genders, with both groups showing significant reductions in stroke risk following carotid revascularization. Studies on restenosis rates yielded mixed results.
Conclusion: Gender differences in outcomes following carotid revascularization are evident, with female patients at higher risk for perioperative complications, yet achieving similar long-term stroke prevention benefits as male patients. While gender-related factors like comorbidities and anatomical differences may contribute to these outcomes, more focused research is needed to clarify the underlying mechanisms and improve personalized management strategies for both genders.
Keywords: Gender differences, carotid revascularization, carotid endarterectomy, carotid artery stenting, perioperative complications, stroke prevention, restenosis, long-term survival
