Outcomes were similar in men and women in both the CEA and medical management groups.427 In subgroup analyses of some trials comparing medi- cal management to CEA in patients with symptomatic or asymptomatic carotid stenosis, women appeared to derive less benefit from surgery than men, potentially because of an increased risk of perioperative events411 413 ; however, the data were inconclusive because of small sample sizes within sex strata and the post hoc nature of some of the analyses. Only 1 trial, the Asymptomatic Carotid Surgery Trial, conducted a prespecified secondary analysis by sex Although for all the subgroup analyses, the results were similar to that first found in the Asymptomatic Carotid they were statistically significant only for the European Carotid Surgery Trial, but this was a post hoc analysis.411 CEA Versus Carotid Artery Stenting Carotid artery stenting (CAS) has emerged as an alternative strategy for the management of carotid stenosis.414 416,429,430 In a meta-analysis of 3 European trials comparing CEA to CAS in symptomatic patients, there was no interaction between sex and 120-day outcome.431 The North American Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) assigned 2502 patients with symptomatic and asymptomatic carotid stenosis to either CEA or CAS. Roughly 35% (n=872) of the subjects were women. 