Os serviços de tratamento oncológico no Brasil estão concentrados nos municípios de grande e médio porte. Dessa forma, muitos pacientes precisam se deslocar para realizar tratamento oncológico.  O objetivo foi avaliar o impacto da realização do tratamento oncológico fora do domicílio na perspectiva de pacientes. Estudo transversal. O recrutamento dos pacientes oncológicos foi feito por meio da técnica “bola de neve”, em âmbito nacional. A coleta de dados foi realizada de forma online. A amostra final contemplou 41 pacientes, a idade dos participantes variou de 21 a 80 anos, com média de 43,22 anos. Os participantes eram predominantemente casados, possuíam em média dois filhos, ensino superior completo e cor de pele branca. A neoplasia maligna e a comorbidade mais frequentes foram o câncer de mama feminino e a hipertensão arterial sistêmica. Os participantes realizaram tratamento em 12 estados e no Distrito Federal, sendo em São Paulo a maior concentração deles. A distância média percorrida pelos participantes do estudo para realização do tratamento foi de 287,15 km e o tempo médio de 3,47 h. Os principais impactos que se apresentaram como dificuldades foram: cansaço, dificuldade financeira, alimentação inadequada, piora do padrão de sono e apoio familiar, dentre outros. Os benefícios relatados foram: melhora do acompanhamento da equipe de saúde, apoio familiar e melhores estruturas para o tratamento. O cansaço, dificuldade financeira, alimentação inadequada, piora do padrão do sono e apoio familiar foram relatados como impactos negativos do tratamento fora do domicílio, mas, também esse tratamento oferece benefícios como melhora do acompanhamento pela equipe de saúde, apoio familiar e melhor estrutura para o tratamento.

Background Peripheral artery disease (PAD) is a major challenge worldwide and endovascular revascularization is an important component of treatment that is affected by COVID-19 restrictions. Purpose Here, we evaluated the impact of COVID-19 restriction on angioplasty service and outcome of patients undergoing lower limb angioplasty. Methods Consecutive patients undergoing endovascular revascularisation between August 2018-March 2021 in a UK district general hospital were analysed retrospectively. Indications for angioplasty of all patients were discussed and agreed upon in multi-disciplinary teams. We compared time from referral to angioplasty, patient and procedural characteristics, technical success, peri-procedural complications, and outcome (wound healing, major amputation, target lesion revascularization, death) in patients treated 'before' and after February 2020 (“during COVID-19”). Results One hundred nineteen patients were treated 'before' (92% critical limb ischaemia [CLI]; 60% diabetes mellitus) and 72 were treated 'during COVID-19' (96% CLI; 61% diabetes mellitus). While the total monthly number of patients treated did not change, the number of outpatients treated as day cases increased (40% to 72%) and overnight stays for social reasons decreased (16% to 10%). Treatment of hospitalized patients decreased from 44% to 18%. The percentage of outpatients treated at <14 days after referral increased from 39% to 63% and hospitalized patients treated <5 days from 47% to 54%. Neither COVID-19 nor time to procedure affected wound healing (p(log Rank) = 0.451; median time to healing 168±25 days) and amputation free survival (p(log Rank) = 0.924; median survival 368±30 days) in all CLI patients significantly. However, amputation-free survival was significantly worse in hospitalized as compared to outpatients (p(log Rank) <0.001; median survival 155±20 vs 368±30 days) with similar wound healing in those that survived (p(log Rank) = 0.340; median time to wound healing 168±25 days). Of note, the known causes of death were sepsis (32%), pneumonia (18%), COVID pneumonia (18%), cardiac (16%) and stroke (8%). Conclusions Adapting to COVID-19 restriction we maintained a safe and effective angioplasty service while shortening waiting times. Very high mortality rates in patients after hospitalization indicated that CLI need to be treated much earlier and more aggressively to avoid disease progression requiring hospitalization. FUNDunding Acknowledgement Type of funding sources: None.