Introduction: Although endovascular correction is a promising perspective, the gold-standard treatment for thoracoabdominal aortic aneurisms and type-B dissections with visceral involvement remains open surgery, particularly due to its well-established long-term durability. This study aims to describe and evaluate public data from patients treated for thoracoabdominal aortic aneurism in the Brazilian public health system in a 12-year interval.
Methods: Data from procedures performed between 2008 and 2019 were extracted from the national public database (Departamento de Informática do Sistema Único de Saúde, or DATASUS) using web scraping techniques. Procedures were evaluated regarding the yearly frequency of elective or urgency surgeries, in-hospital mortality, and governmental costs. All tests were done with a level of significance P<0.05.
Results: A total of 812 procedures were analyzed. Of all surgeries, 67.98% were elective cases. There were 328 in-hospital deaths (mortality of 40.39%). In-hospital mortality was lower in elective procedures (26.92%) than in urgency procedures (46.74%) (P=0.008). Total governmental expenditure was $3.127.051,56 - an average of $3.774,22 for elective surgery and $3.791,93 for emergency surgery (P=0.999).
Conclusion: The proportion of urgency procedures is higher than that recommended by international literature. Mortality was higher for urgent admissions, although governmental costs were equal for elective and urgent procedures; specialized referral centers should be considered by health policy makers.
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http://dx.doi.org/10.21470/1678-9741-2021-0291 | DOI Listing |
J Clin Med
January 2025
Department of Vascular Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
: The parallel stent graft endovascular aortic repair (PGEVAR) technique is an off-the-shelf option used for elective complex abdominal aortic aneurysm repair with acceptable outcome results, as reported so far. The PGEVAR technique, using chimney or periscope parallel grafts, can also be used for patients with ruptured complex abdominal aortic aneurysms. However, only few data about the mid- to long-term outcomes are available.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Vascular Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany.
Thoracoabdominal aortic aneurysms (TAAAs) are rare but serious conditions characterized by dilation of the aorta characterized by remodeling of the vessel wall, with changes in the elastin and collagen content. Individuals with Marfan syndrome have a genetic predisposition for elastic fiber fragmentation and elastin degradation and are prone to early aneurysm formation and progression. Our objective was to analyze the medial collagen characteristics through histological, polarized light microscopy, and electron microscopy methods across the thoracic and abdominal aorta in twenty-five patients undergoing open surgical repair, including nine with Marfan syndrome.
View Article and Find Full Text PDFEur Radiol
January 2025
Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.
Objectives: The purpose of this study was to evaluate whether the iodine contrast in blood and solid organs differs between men and women and to evaluate the effect of BMI, height, weight, and blood volume (BV) on sex-specific contrast in staging CT.
Materials And Methods: Patients receiving a venous-phase thoracoabdominal Photon-Counting Detector CT (PCD-CT) scan with 100- or 120-mL CM between 08/2021 and 01/2022 were retrospectively included in this single-center study. Image analysis was performed by measuring iodine contrast in the liver, portal vein, spleen, left atrium, left ventricle, pulmonary trunk, ascending and descending aorta on spectral PCD-CT datasets.
JTCVS Open
December 2024
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.
Objective: Giant cell arteritis (GCA) may present as proximal aortic pathology requiring surgical intervention. We present our experience with surgical management of GCA in patients presenting with proximal aortic disease.
Methods: From January 1993 to May 2020, 184 adult patients were diagnosed with GCA on histopathology after undergoing cardiac surgery.
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