Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202400041
Jornal Vascular Brasileiro
Original Article

Estudo transversal multicêntrico comparando o gênero no reparo endovascular de aneurismas de aorta abdominal infrarrenal. Resultados do Registro dos Hospitais Estaduais Universitários do Interior de São Paulo (RHEUNI)

Cross-sectional, multicenter study comparing sex differences in patients undergoing endovascular repair of infrarenal abdominal aortic aneurysms. Results from the São Paulo State University Provincial Hospitals Registry (RHEUNI)

Regina Moura; Edwaldo Edner Joviliano; Ana Terezinha Guillaumon; Selma Regina de Oliveira Raymundo; Ludwig Hafner; Marcone Lima Sobreira; Marcelo José de Almeida; Daniel Gustavo Miquelin; Martin Geiger; Winston Bonetti Yoshida

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Resumo

Contexto: O aneurisma da aorta abdominal (AAA) afeta 4-6 vezes mais frequentemente os homens do que as mulheres, porém nas mulheres o prognóstico costuma ser pior.

Objetivo: Comparar os procedimentos endovasculares para correção de AAA infrarrenal em homens e mulheres, usando dados de um registro prospectivo.

Métodos: Esse registro foi feito em cinco hospitais universitários do estado de São Paulo entre 2012 e 2022. Foi realizado um estudo transversal, compilando dados demográficos, anatômicos (diâmetro do aneurisma, colo curto, angulado, calcificado ou com trombo; colo distal < 1,5 cm e artérias ilíacas tortuosas, alteradas), complicações (vazamentos, conversões, perviedade ou estenoses de ramos) e insuficiência renal e mortalidade em 30 dias. Foram utilizados o teste de qui-quadrado e teste t de Student, com significância de 5%. O estudo foi aprovado pelo Comitê de Ética (processo 4040-2011).

Resultados: Um total de 152 (15,9%) dos pacientes eram mulheres e 799 (84,0%) eram homens (p < 0,05). A maior parte eram brancos (80,2% das mulheres e 87,4% dos homens). Diabetes e hipertensão foram significativamente mais frequentes nas mulheres. O formato foi fusiforme, principalmente nas mulheres (95,39% versus 89,86% nos homens). O diâmetro médio foi menor nas mulheres (5,96 cm versus 6,49 cm; p = 0,0056). As artérias ilíacas foram menos envolvidas nas mulheres (89,40% versus 73,58%; p = 0,00001). A perda sanguínea foi maior nos homens (321,40 ml versus 168,84 ml nas mulheres; p < 0,05). A mortalidade operatória foi similar entre os sexos, mas as obstruções foram mais frequentes nas mulheres (15,2% versus 13,51%; p = 0,017296).

Conclusões: Nas mulheres, o diâmetro aneurismático foi menor e as complicações obstrutivas foram mais frequentes.

Palavras-chave

aneurisma de aorta abdominal; procedimentos endovasculares; complicações pós-operatórias; estudos de gênero; mortalidade

Abstract

Background: Abdominal aortic aneurysms (AAA) are 4-6 times more frequent among men than among women, but prognosis tends to be worse in women. Objective: To compare endovascular procedures to repair infrarenal AAA in men and women, using data from a prospective registry.

Methods: This registry collected data from five university hospitals in the state of São Paulo (Brazil) from 2012 to 2022. A cross-sectional study was conducted compiling demographic data, anatomic variables (aneurysm diameter, short neck, angulated neck, calcified neck, or thrombosed neck; distal neck < 1.5 cm, and tortuous, abnormal iliac arteries), complications (leaks, conversions, and patency or stenosis of branches) and renal failure and mortality at 30 days. The chi-square test and Student’s t test were applied with a 5% significance level. The study was approved by the Ethics Committee (process 4040-2011).

Results: A total of 152 (15.9%) of the patients were women and 799 (84.0%) were men (p < 0.05). The majority were white (80.2% of the women and 87.4% of the men). Diabetes and hypertension were significantly more frequent among the women. The most prevalent shape was fusiform, particularly among the women (95.39% vs. 89.86% among men). Mean diameter was smaller among the women (5.96 cm vs. 6.49 cm; p = 0.0056). The iliac arteries were less often involved among the women (89.40% vs. 73.58%; p = 0.00001). Blood loss was greater in the men (321.40 ml vs. 168.84 ml among the women; p < 0.05). Operative mortality was similar in both sexes, but obstructions were more frequent among the women (15.2% vs. 13.51%; p = 0.017296).

Conclusions: Aneurysmal diameter was smaller and obstructive complications were more frequent among women.

Keywords

abdominal aortic aneurysm; endovascular procedures; postoperative complications; sex distribution studies; mortality

References

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Submitted date:
05/19/2024

Accepted date:
06/27/2024

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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