Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.202400772
Jornal Vascular Brasileiro
Original Article

Complications of use of vascular devices during the covid-19 pandemic: a retrospective cohort

Complicações no uso de dispositivos vasculares no período da pandemia de covid-19: uma coorte retrospectiva

Johann Viktor Müller; Wander Eduardo Sardinha; José Manoel da Silva Silvestre; Guilherme da Silva Silvestre; Ualid Saleh Hatoum; Natália Scaneiro Boy Sardinha; Renne Rodrigues; Mariana Ragassi Urbano

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Abstract

Background: During the COVID-19 pandemic, there was a substantial increase in the number of severely ill hospitalized patients, which coincided with a corresponding increase in the consumption of medical supplies, including vascular devices. In this context, vascular surgeons perceived an absolute increase in complications associated with their use.

Objectives: To calculate the rate of severe complications requiring surgical vascular intervention following vascular device implantation during the COVID-19 pandemic.

Methods: A retrospective cohort was conducted to investigate complications associated with vascular devices, such as central venous catheters (CVC), arterial lines, peripherally inserted central catheters (PICCs), totally implantable venous catheters, and semi-implantable venous catheters. The exposed population was defined based on the number of vascular devices used during the pandemic period, identified using the WPDHOSP materials management software. A total of 1,708 consultations with the vascular surgery team were analyzed using Medview medical record software. Patient records were evaluated, selecting those requiring vascular intervention.

Results: Out of a total of 16,988 vascular devices used, 25 patients needed surgical or endovascular vascular interventions. This corresponds to a severe complication rate of 0.14%. The complications found were intravascular foreign body, active bleeding, pseudoaneurysm, unintentional arterial implantation, expanding cervical hematoma, acute limb ischemia, and arteriovenous fistula. Patients underwent vascular procedures such as foreign body removal, arterial repair, arterial embolization, endovascular stenting, arterial thrombectomy, and arteriovenous fistula repair.

Conclusions: The severe complication rate is consistent with incidences found in the pre-pandemic literature.

Keywords

intraoperative complications; vascular surgical procedures; vascular access devices; foreign bodies

Resumo

Contexto: Durante a pandemia de covid-19, houve um aumento substancial no número de pacientes gravemente hospitalizados, que coincidiu com um aumento correspondente no consumo de insumos médicos, inclusive de dispositivos vasculares. Nesse contexto, os cirurgiões vasculares perceberam um aumento nas complicações associadas ao uso desses dispositivos.

Objetivos: Calcular a taxa de complicações graves que requerem intervenção vascular após o implante de dispositivos vasculares durante a pandemia de covid-19.

Métodos: Foi conduzido um estudo de coorte retrospectivo para investigar complicações associadas a dispositivos vasculares, como cateteres venosos centrais, linhas arteriais, cateteres centrais de inserção periférica, cateteres venosos totalmente implantáveis e cateteres venosos semi-implantáveis. A população exposta foi definida com base no número de dispositivos utilizados durante o período da pandemia, identificado por meio do software de gestão de materiais WPDHOSP. Um total de 1.708 consultas da equipe de cirurgia vascular foi analisado usando o software de prontuário médico Medview. Os prontuários dos pacientes foram avaliados, incluindo aqueles que necessitaram de intervenção cirúrgica vascular.

Resultados: Vinte e cinco pacientes necessitaram de intervenção cirúrgica ou endovascular de um total de 16.988 dispositivos utilizados. Isso corresponde a uma taxa de complicações graves de 0,14%. As complicações encontradas foram corpo estranho intravascular, sangramento ativo, pseudoaneurisma, implante arterial inadvertido, hematoma cervical expansivo, isquemia aguda de membro e fístula arteriovenosa. Os pacientes foram submetidos a procedimentos vasculares como retirada de corpo estranho, reparo arterial, embolização arterial, colocação de stent endovascular, trombectomia arterial e reparo de fístula arteriovenosa.

Conclusões: A taxa de complicações graves é consistente com as incidências encontradas na literatura pré-pandemia.

Palavras-chave

complicações intraoperatórias; procedimentos cirúrgicos vasculares; dispositivos de acesso vascular; corpos estranhos

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Submitted date:
06/17/2024

Accepted date:
11/25/2024

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