CONTEXT: Doppler ultrasonography is an established method for diagnosis, preoperative imaging and follow-up of extracranial carotid artery disease. OBJETIVE: The evaluation of gender differences in carotid artery bifurcation Doppler ultrasonography mapping. METHODS: High resolution Doppler ultrasonography of 500 carotid bifurcations was performed in 192 women and 308 men before surgical treatment. Gender differences were analyzed based on B-mode, color-flow, duplex doppler transverse and longitudinal images. Diameter percent stenoses, plaque length, distal internal and common carotid artery diameters, and distance from the carotid bifurcation to the ear lobe were compared. Mean, standard deviation, minimum and maximum values were described. Statistical comparisons were performed based on Student's t and Χ2 tests. RESULTS: Carotid stenoses averaged 70±11% (30-95%) in women and 72±12% (40-98%) in men (p=0.013). The prevalence of 90-99% stenosis was greater in men, 14.3 vs 7.8% (p=0.029). Carotid plaques were longer in men, 2.3±0.8 vs 1.9 ±0.6 cm (p<0.001). Mean diameters of the distal internal carotid artery, 4.9±0.9 vs 4.6 ±0.8 mm, and of the common carotid artery, 7.6±1.3 vs 7.1±1.4 mm, were greater in men (p=0.001). The distance from the ear lobe to the bifurcation was also greater in men, 5.9±1.1 vs 5.3±0.9 cm (p<0.001). CONCLUSIONS: Doppler ultrasonography preoperative mapping demonstrated that the parameters measured were greater in men than in women. Detailed planning of carotid plaque treatment must take into consideration individual differences such as those associated with the patient's gender.
ultrasonography; carotid stenosis; surgery
