ANTONIO EDUARDO ZERATI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Epidemiology of Abdominal Aortic Aneurysm Repair in Brazil from 2008 to 2019 and Comprehensive Review of Nationwide Statistics Across the World(2022) LOUZADA, Andressa Cristina Sposato; SILVA, Marcelo Fiorelli Alexandrino da; PORTUGAL, Maria Fernanda Cassino; STABELLINI, Nickolas; ZERATI, Antonio Eduardo; AMARO, Edson; TEIVELIS, Marcelo Passos; WOLOSKER, NelsonIntroduction Studying epidemiology of abdominal aortic aneurysms repairs is essential to prevent related deaths. Although outcomes are influenced by socioeconomic factors, there are no nationwide studies on these statistics in low-and-middle income countries. Therefore, we designed this study to evaluate abdominal aortic aneurysms repair rates, trends, costs, and in-hospital mortality in the Brazilian Public Health System, which exclusively insures over 160 million Brazilians. Material and Methods Retrospective cross-sectional population-based analysis of publicly available data referring to all abdominal aortic aneurysm repairs performed between 2008 and 2019 in Brazilian public hospitals. Results We observed a total of 13,506 abdominal aortic aneurysm repairs, of which 32% were emergency endovascular repairs, 20% emergency open repairs, 32% elective endovascular repairs and 16% elective open repairs. There has been a downward trend in total abdominal aortic aneurysms repairs and an increasing predominance of endovascular repair. Elective and endovascular repairs were significantly associated with lower in-hospital mortality. For ruptured abdominal aortic aneurysms, we observed mortality rates of 13.8% after endovascular repair and 52.1% after open repair. For intact abdominal aortic aneurysms, we observed mortalities of 3.8% after endovascular repair and 18.6% after open repair. Procedure and mortality rates varied significantly among the Brazilian regions. Conclusions We observed a low and decreasing rate of abdominal aortic aneurysm repair. Most repairs were emergency and endovascular and there was an increasing predominance of endovascular repair. Endovascular and elective repairs were associated with lower mortality.
- Epidemiological analysis of lower limb revascularization for peripheral arterial disease over 12 years on the public healthcare system in Brazil(2022) WOLOSKER, Nelson; SILVA, Marcelo Fiorelli Alexandrino da; PORTUGAL, Maria Fernanda Cassino; STABELLINI, Nickolas; ZERATI, Antônio Eduardo; SZLEJF, Claudia; AMARO JUNIOR, Edson; TEIVELIS, Marcelo PassosAbstract Background Worldwide, peripheral arterial disease (PAD) is a disorder with high morbidity, affecting more than 200 million people. Objectives Our objective was to analyze surgical treatment for PAD provided on the Brazilian Public Healthcare System over 12 years using publicly available data. Methods The study was conducted with analysis of data available on the Brazilian Health Ministry’s database platform, assessing distributions of procedures and techniques over the years and their associated mortality and costs. Results A total of 129,424 procedures were analyzed (performed either for claudication or critical ischemia, proportion unknown). The vast majority of procedures were endovascular (65.49%) and this disproportion exhibited a rising trend (p<0.001). There were 3,306 in-hospital deaths (mortality of 2.55%), with lower mortality in the endovascular group (1.2% vs. 5.0%, p=0.008). The overall governmental expenditure on these procedures was U$ 238,010,096.51, and endovascular procedures were on average significantly more expensive than open surgery (U$ 1,932.27 vs. U$ 1,517.32; p=0.016). Conclusions Lower limb revascularizations were performed on the Brazilian Public Healthcare System with gradually increasing frequency from 2008 to 2019. Endovascular procedures were vastly more common and were associated with lower in-hospital mortality rates, but higher procedure costs.
- Vascular Access(2022) SAES, G. F.; ZERATI, A. E.; WOLOSKER, M. B.; BARBOSA, J. A. S.; SILVA, T. C. do CampoIn this chapter, we deal with vascular accesses in cancer patients, complications associated with those devices, and nursery care. Long-term venous catheters, especially tunneled catheters, are essential for cancer treatment, with wide applicability in various stages of treatment. In addition to enabling the infusion of drugs and blood products, they also allow the collection of blood samples for laboratory analysis, the monitoring of hemodynamic parameters, parenteral nutrition, and the performance of essential procedures for maintaining life, such as hemodialysis sessions.The indications and types of catheters are discussed, taking into account the time of use, the compatibility of the drug with the peripheral venous system, and the risk of infection. Most frequent complications and how to avoid them are also a subject in this chapter. © Springer Nature Switzerland AG 2022.