Jak postępować w zwężeniu tętnic szyjnych u kobiet? Krótki przegląd wybranych badań i wytycznych

Abstract

Abstract Since the 1990s, stroke in women has been a serious health and socioeconomic problem. Some of the data provided by the American Heart Association Statistics Committee and Stroke Statistics Subcommittee proves that, in recent years, the prevalence of stroke with an unfavourable outcome is even higher in women than in men, while the risk of suffering from stroke in older women is even higher than in men. Although atrial fibrillation is a more common cause of stroke in women, it is worth remembering that carotid artery stenosis can also be a possible cause. Until recently, there were no guidelines and recommendations regarding the treatment of carotid stenosis (CS) in women and the available methods were mainly recommended for men. In recent years, however, it has been proven that endarterectomy (CEA) and stenting (CAS) are equally effective in the prevention of stroke induced by carotid stenosis in women and in men, whereas prompt and proper treatment of risk factors reduces the risk associated with both procedures within the first thirty days following the operation. Endarterectomy with patching, considered to be the safest procedure, is the preferred treatment for stenosed artery. In women with symptomatic changes in carotid arteries a CEA should, as is the case with men, preferably be performed within the first two weeks after the vascular event occurred. However, the optimal timing for the performance CAS after the occurrence of cerebral symptoms is yet to be determined. The type and technique of the procedure should be chosen for every woman individually. All risk factors should always be treated and patients should be strongly encouraged to alter their lifestyle. This paper presents a review of current studies and suggested guidelines in treating carotid artery stenosis in women in order to prevent the occurrence of stroke.