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Table 2 Possible reasons for gender differences for carotid endarterectomy

From: Meta- analysis and meta-regression analysis of the associations between sex and the operative outcomes of carotid endarterectomy

  Possible reasons for gender differences Reference
Epidemiology   
  Older age of onset of cerebrovascular disease in women [97]
Plaque characteristics   
  Higher rates of carotid artery stenosis, [97]
Lower and more stable plaque burden for the same degree of carotid artery stenosis in females compared with males
Anatomy   
  Female carotid arteries are higher- velocity vessels with increased outflow/inflow ratio, [97100]
Women tend to have atherosclerotic plaque relatively localized and mainly distributed in the common carotid as opposed to the proximal internal carotid artery, usually seen in men
  Smaller ICA size in women that might in turn lead to a higher incidence of early (immediate thrombosis, postoperative microembolization) and late (recurrent stenosis, ipsilateral stroke) postoperative complications [78, 101105]
Surgery   
  Higher surgical risk in women [97]
Pathophysiology   
  Lower cerebrovascular reserves in women, as cerebrovascular reactivity after hypercapnia was found to be more impaired in postmenopausal women compared with men of the same age [97100]