Rev Col Bras Cir. 2026 Oct 5;53:e2026004426. doi: 10.1590/0100-6991e-2026004426-en. eCollection 2026.
ABSTRACT
INTRODUCTION: Acute Arterial Occlusions are vascular emergencies associated with substantial morbidity and mortality. In Brazil, the role of arterial embolectomy within the Brazilian Unified Health System (SUS) remains incompletely characterized, particularly in the context of the expansion of endovascular therapies and the impact of the COVID-19 pandemic.
METHODS: This ecological time-series study used secondary data from the Hospital Information System (SIH-SUS), including hospitalizations for arterial embolism and thrombosis (ICD-10: I74.*) between 2016 and 2025. Arterial embolectomies were identified using procedure codes. Temporal trends were assessed using Prais-Winsten regression, with estimation of the annual percent change (APC).
RESULTS: A total of 240,350 hospitalizations were identified, of which 46,439 (19.3%) involved arterial embolectomy. Patients were predominantly older adults, male, and admitted on an emergency basis. The overall in-hospital mortality rate was 10.3%. Procedures were concentrated in the Southeast region, whereas the highest mortality rates were observed in the North. A significant downward temporal trend was identified (APC: -5.4%), with a 25.8% reduction over the study period and an inflection after 2022, consistent with changes in disease management patterns and possible repercussions of the COVID-19 pandemic.
CONCLUSION: Arterial embolectomy remains relevant in emergency vascular care within the Brazilian Unified Health System, despite the temporal decline in the number of procedures, possibly related to multiple factors, including advances in cardiovascular prevention and changes in therapeutic strategies. High mortality and regional disparities highlight inequalities in access to specialized care, reinforcing the need for strategies aimed at strengthening the vascular care network.
PMID:42848611 | DOI:10.1590/0100-6991e-2026004426-en