Evolução clínica tardia de pacientes multiarteriais tratados por revascularização percutânea e cirúrgica

Centemero, Marinella; Sousa, J. Eduardo; Jatene, Adib; Paulista, Paulo P; Souza, L. C. B.; Sousa, Amanda G. M. R.; Feres, Fausto; Staico, Rodolfo; Mattos, Luiz Alberto; Abizaid, Alexandre; Maldonado, Galo; Tanajura, Luiz Fernando; Chaves, Áurea J.; Lasave, Leandro

doi:10.1590/s2179-83972007000100009

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“…Mesmo quando os pacientes foram seguidos por muitos anos, nenhuma diferença foi observada. Contudo, a ICP foi associada a risco significativamente maior para subseqüentes revascularizações [4][5][6][7][8][9][10][11][12][13][14] .…”

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Avaliação do custo do implante programado de múltiplos stents em mais de uma intervenção percutânea em pacientes com doença coronária multiarterial

Pedroso¹,

Meireles²,

Filho³

et al. 2007

Rev. Bras. Cardiol. Invasiva

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Background:The Brazilian Public Health System (SUS) establishes that coronary angioplasties with implantation of two stents must not exceed 20% of the total amount of angioplasties performed, resulting in the necessity of staged procedures in the majority of the patients with multivessel coronary disease. The objective of this study was to compare the costs of the staged stent implantation policy, imposed by SUS, with the stent implantation approach considered ideal by the interventional cardiology team, in patients with multivessel coronary disease. Methods: Costs were compared in a consecutive cohort of 100 patients with multivessel disease with indication of complete revascularization by percutaneous coronary intervention. Coronary angiographies had been previously evaluated by the interventional cardiology team that had individualized the approach considered ideal for the treatment of each patient. Procedures were then performed in accordance to SUS multistage policy and the costs of the two treatment strategies were compared. Of note, a single stent implantation procedure costs R$4,298.00 according to the SUS price list. Results: Mean age was 61.5±10.7 years, 66% were male, 43% diabetics and 67% had stable angina. Agreement in relation to the SUS staged procedures occurred in 44% and discordance in 56%. An excess of 58 procedures was detected, generating an additional cost of R$131,298.00. Conclusions: The multistaged approach imposed by SUS increases the number of procedures for coronary stent

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