Article Text

Download PDFPDF
Effect of body size on operative risk of carotid endarterectomy
  1. S R Messé1,
  2. S E Kasner1,
  3. Z Mehta2,
  4. C P Warlow3,
  5. P M Rothwell2,
  6. for the European Carotid Surgery Trialists
  1. 1Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, PA, USA
  2. 2Stroke Prevention Research Unit, Department of Clinical Neurology, University of Oxford, Oxford, UK
  3. 3Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
  1. Correspondence to:
 Dr Scott E Kasner
 Department of Neurology, Comprehensive Stroke Center, University of Pennsylvania Medical Center, 3W Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, USA;


Many studies have found that women have a higher risk of perioperative stroke or death from carotid endarterectomy. Other vascular surgical procedures have demonstrated that body size and morphology impact on operative risk. We correlated the 30 day operative risk of stroke and death in the European Carotid Surgery Trial (ECST) with height, weight, body surface area (BSA), and body mass index using single variable analyses and multivariable logistic regression. Women were at significantly higher risk of perioperative stroke and death in the ECST. Both height and BSA confounded the effect of sex, implying that the generally smaller size of women may contribute to their increased risk. This finding should be validated in other large datasets.

  • BMI, body mass index
  • BSA, body surface area
  • CEA, carotid endarterectomy
  • ECST, European Carotid Surgery Trial
  • carotid arteries
  • carotid endarterectomy
  • risk factors

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Dr Messe was supported by an EVEREST Research Scholarship Award. Dr Kasner was supported by NIH K23 award NS02147. Dr Rothwell and Dr Mehta were supported by the UK Medical Research Council. The ECST was funded by the UK Medical Research Council.

  • Competing interests: none declared