Abstract
OBJECTIVES:In Brazil, descending thoracic aorta disease, including aneurysms and dissections, is managed preferentially by endovascular treatment, owing to its feasibility and good results. In this study, we analyzed endovascular treatment of isolated descending thoracic aortic disease cases in the Brazilian public health system over a 12-year period.METHODS:Public data from procedures performed from 2008 to 2019 were extracted using web scraping techniques to assess procedure type frequency (elective or urgency), mortality, and governmental costs.RESULTS:A total of 5,595 procedures were analyzed, the vast majority of which were urgent procedures (61.82% vs. 38.18%). In-hospital mortality was lower for elective than for urgent surgeries (4.96 vs.10.32% p=0.008). An average of R$16,845.86 and R$20,012.04 was paid per elective and emergency procedure, respectively, with no statistical difference (p=0.095).CONCLUSION:Elective procedures were associated with lower mortality than urgent procedures. There was no statistically significant difference between elective and urgent procedures regarding costs.
Highlights
Thoracic aortic disease (TAD) encompasses aneurysms and acute aortic syndromes
In this study, we aimed to evaluate the endovascular management of isolated descending TAD (I-DTAD), encompassing all procedures performed in the public health system from 2008 to 2019, assessing procedure type frequency, mortality, and governmental costs
A total of 5,595 endovascular procedures were performed by the Brazilian public health system from 2008 to 2019 for I-DTAD correction
Summary
Thoracic aortic disease (TAD) encompasses aneurysms and acute aortic syndromes (dissections, intramural hematomas, and penetrating atherosclerotic ulcers). The most frequent presentation, are localized permanent dilatations covering X50% of an artery’s diameter [1,2,3]; the thoracic aortic size thresholds for elective repair indication are determined by the dilation location and underlying etiology [4]. Current guidelines recommend surgical repair from a 5.5-cm diameter for idiopathic or sporadic dilatations, and a lower threshold of 5 cm in case of Marfan syndrome or a familial thoracic aortic aneurysm [5]. While thoracic aortic aneurysms are typically asymptomatic, acute types usually present with acute chest or back pain [4].
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