Duplex imaging findings predict stenosis after carotid endarterectomy

Abstract

Duplex scanning within a week of carotid endarterectomy identifies > 50% residual stenosis, in addition to minor residual 25% to 50% stenosis and small carotid dimensions, which are good predictors of > 50% restenosis at 6 months.

Mechanisms of gender-related outcome differences after carotid endarterectomy

“…Main findings ‫ء‬Vessel diameter Golledge et al 24 Preoperative, women generally had smaller carotid artery diameter than men. ‫ء‬Plaque morphology Hellings et al 25 Women have more stable and less inflammatory plaque phenotype compared with men.…”

“…This resulted in one additional article focusing on the difference in vessel diameter between men and women. 24 We wish to emphasize that this review did not aim to describe and summarize the actual outcome differences between men and women after CEA and all their theoretically related causes. We purposely focused our search on studies determining and specifying causal (gender-related) factors of the reported outcome difference.…”

“…18,32 In our search, one article described the impact of duplex ultrasound scan-measured carotid artery diameter on post-CEA outcome and specified this for gender. 24 This study on 192 symptomatic patients, however, did not look at perioperative outcome between men and women, but focused on the relation between carotid artery diameter and occurrence of restenosis. Before the operation, men generally had a larger diameter of the internal carotid artery (ICA) than women.…”

“…Preop- Table I. Summary of the main findings of included studies [24][25][26][27][28][29][30][31][32][33][34] Factor…”

Gender-related risk factors for perioperative stroke after carotid endarterectomy in symptomatic patients

“…It is worth mentioning that none of the above-mentioned studies analyze more than 1 factor simultaneously. [19][20][21][22][23][24][25][26][27][28][29] However, the overall evidence for outcome differences by gender-specific characteristics in the literature is limited. 30 Mantese et al found that sex did not modify the treatment effect.…”