Angioplastia em cirurgia vascular: incidência e fatores relacionados

Abstract

Introduction: Percutaneous transluminal angioplasty (PTA) is a minimally invasive technique that has been increasingly used in the treatment of vascular diseases, reflecting the advancement of endovascular methods in the Brazilian clinical setting. Objective: To estimate the incidence and identify factors associated with the angioplasty procedure among patients undergoing vascular surgery. Methods: A retrospective cohort study was conducted including patients who underwent vascular surgery between 2019 and 2022 at a tertiary hospital in Passo Fundo, Rio Grande do Sul, Brazil. Sociodemographic, clinical, and procedural variables were analyzed. The incidence of the outcome was estimated with a 95% confidence interval (95% CI), and Pearson’s chi-square test was used to assess the distribution of angioplasty according to the exposure variables. Results: The sample consisted of 1,229 patients, predominantly elderly, white men with low educational level, smokers, and presenting multiple comorbidities: systemic arterial hypertension (71.8%), diabetes mellitus (39.1%), insulin dependence (12.7%), dyslipidemia (28.6%), acute myocardial infarction (5.0%), heart failure (6.1%), stroke (3.9%), carotid stenosis (4.4%), peripheral arterial disease (44.8%), and acute peripheral arterial occlusion (8.6%). The incidence of angioplasty was 57% (95% CI 55–60). The most frequent technique involved stent placement (50.2%), and the superficial femoral artery was the most common target vessel (31.9%). The procedure was significantly more frequent among elderly patients (61.0%; p<0.001), those with high school education or less (59.1%; p=0.038), smokers (63.7%; p<0.001), hypertensive patients (62.5%; p<0.001), diabetic patients (71.8%; p<0.001), insulin-dependent patients (75.0%; p<0.001), patients with dyslipidemia (68.4%; p<0.001), history of myocardial infarction (81.0%; p<0.001), carotid stenosis (80.8%; p=0.001), peripheral arterial disease (78.6%; p<0.001), and acute peripheral arterial occlusion (67.3%; p=0.039). Conclusion: The findings indicate that patients undergoing angioplasty were predominantly elderly, white male smokers with multiple comorbidities.