학술논문

Identifying sex-specific differences in the carotid revascularisation literature: findings from a scoping review
Document Type
article
Source
Stroke and Vascular Neurology. 6(3)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Clinical Research
Patient Safety
Clinical Trials and Supportive Activities
Stroke
Brain Disorders
7.3 Management and decision making
Management of diseases and conditions
Cardiovascular
Carotid Arteries
Carotid Stenosis
Endarterectomy
Carotid
Female
Humans
Male
Stents
Treatment Outcome
atherosclerosis
intervention
stenosis
stent
WoW-CAD Investigators
Language
Abstract
ObjectiveNo systematic review of the literature has dedicated itself to looking at the management of symptomatic carotid stenosis in female patients. In this scoping review, we aimed to identify all randomised controlled trials (RCTs) that reported sex-specific outcomes for patients who underwent carotid revascularisation, and determine whether sufficient information is reported within these studies to assess short-term and long-term outcomes in female patients.Design, setting and participantsWe systematically searched Medline, Embase, Pubmed and Cochrane libraries for RCTs published between 1991 and 2020 that included female patients and compared either endarterectomy with stenting, or any revascularisation (endarterectomy or stenting) with medical therapy in patients with symptomatic high-grade (>50%) carotid stenosis.ResultsFrom 1537 references examined, 27 eligible studies were identified. Sex-specific outcomes were reported in 13 studies. Baseline patient characteristics of enrolled female patients were reported in 2 of those 13 studies. Common outcomes reported included stroke and death, however, there was significant heterogeneity in the reporting of both periprocedural and long-term outcomes. Sex-specific differences relating to the degree of stenosis and time from index event to treatment are largely limited to studies comparing endarterectomy to medical therapy. Adverse events were not reported by sex.ConclusionsOnly half of the previously published RCTs and systematic reviews report sex-specific outcomes. Detailed analyses on the results of carotid artery intervention for female patients with symptomatic stenosis are limited.