Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492012000400007
Jornal Vascular Brasileiro
Original Article

Aneurisma da aorta abdominal infrarrenal: importância do rastreamento em hospitais do Sistema Único de Saúde na região metropolitana de Salvador - Bahia

Infrarenal abdominal aortic aneurysm: significance of screening in patients of public hospitals in the metropolitan region of Salvador - Bahia, Brazil

Aquiles Tadashi Ywata de Carvalho; Aleksandro de Jesus Santos; Carlos Alberto Pereira Gomes; Marcos Luis Martins; Vanessa Prado dos Santos; Roberto Pastor Rubeiz; Marcio Oliveira Queiroz; Roberto Augusto Caffaro

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Resumo

INTRODUÇÃO: O aneurisma da aorta abdominal infrarrenal (AAA) representa doença vascular que merece constante atenção, tanto para os estudos de rastreamento como de aperfeiçoamento terapêutico. Sua importância clínica se baseia na alta taxa de mortalidade que ocorre com a sua ruptura, em contraste com a baixa taxa de mortalidade descrita com a correção cirúrgica eletiva em serviços especializados. Na região metropolitana de Salvador, não se encontram dados relativos à identificação desses indivíduos. Esse fato encorajou nosso estudo. OBJETIVOS: (1) determinar a prevalência do AAA infrarrenal nos pacientes com fatores de risco; (2) identificar esses fatores de risco; e (3) a população que deve ser rotineiramente rastreada. MÉTODOS: Em estudo de rastreamento do AAA realizado pelos Serviços de Cirurgia Vascular do Hospital Geral Roberto Santos (HGRS) e do Hospital Geral de Camaçari (HGC) de setembro de 2008 a outubro de 2009, foram selecionados 1350 indivíduos com 50 anos ou mais que apresentavam fatores de risco para o aneurisma da aorta. A triagem incluiu o preenchimento de protocolo e a realização de ultrassom doppler colorido. RESULTADOS: A prevalência do AAA infrarrenal nesta amostra foi 3,9%. Os fatores de risco mais frequentemente associados foram: média de idade de 72 anos, gênero masculino, tabagismo, antecedente de AAA e portadores de doença arterial oclusiva periférica, insuficiência coronariana e doença pulmonar obstrutiva crônica. O rastreamento do AAA deve ser considerado em homens com idade superior a 65 anos, principalmente quando presente um desses fatores de risco.

Palavras-chave

aneurisma da aorta abdominal, aneurisma aórtico, programas de rastreamento

Abstract

BACKGROUND: Infrarenal abdominal aortic aneurysm (AAA) is a vascular disease requiring continuous attention both in terms of screening and therapeutic improvement. Infrarenal AAA is a major condition because of its high mortality rate due to AAA rupture, as opposite to the low mortality rate related to elective surgical repair conducted in specialized facilities. In the metropolitan area of Salvador there are no data concerning the identification of patients with infrarenal AAA. Such lack of information prompted this study. OBJECTIVE: (1) to determine the prevalence of infrarenal AAA in patients with risk factors; (2) to identify risk factors; and (3) to determine whether the population at risk should be routinely screened. METHODS: In a study for AAA screening conducted by the Department of Vascular Surgery of Hospital Geral Roberto Santos and Hospital Geral de Camaçari from September 2008 to October 2009, 1,350 individuals aged 50 years or older with risk factors for aortic aneurysm were selected. Screening included completion of protocol and performance of color Doppler ultrasound. RESULTS: AAA prevalence in this sample was 3.9%. The most frequent risk factors associated with aneurysm were mean age of 72 years, male gender, smoking, and patients with peripheral obstructive arterial disease, coronary failure, and chronic obstructive lung disease. AAA screening should be considered in men aged over 65 years, mainly when one of these risk factors are present.

Keywords

abdominal aortic aneurysm, aortic aneurysm, screening programs

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