P-128 - LONG-TERM QUALITY OF LIFE AFTER STENTING FOR ACUTE OR CHRONIC DEEP VEIN THROMBOSIS: A CROSS-SECTIONAL STUDY

TOPIC:
Thrombosis
AUTHORS:
Bakas J. (Erasmus University Medical Center ~ Rotterdam ~ Netherlands) , Van Montfrans C. (Erasmus University Medical Center ~ Rotterdam ~ Netherlands) , Moelker A. (Erasmus University Medical Center ~ Rotterdam ~ Netherlands) , Van Rijn M.J. (Erasmus University Medical Center ~ Rotterdam ~ Netherlands) , Verhagen H. (Erasmus University Medical Center ~ Rotterdam ~ Netherlands)
Introduction:
Deep vein thrombosis (DVT) is a common disease with a worsened quality of life (QOL) if post-thrombotic syndrome (PTS) develops (1,2). Deep venous stenting improves QOL at the short-term, but long-term results are currently lacking (3,4). We aim to report long-term QOL after deep venous stenting in patients with acute DVT and chronic PTS, using the Short Form Health Survey (SF-36) and Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20).
Methods:
We did a cross-sectional study of all patients who underwent venous stenting for acute DVT or PTS from May 2006 until November 2021 at our institution. The SF-36 and CIVIQ-20 were filled out after the procedure between July 2020 and December 2021, at various times of follow-up because of the study design. Primary endpoints were CIVIQ-20 and SF-36 scores at the short- and long-term. Secondary, we compared the CIVIQ-20 and SF-36 outcomes between acute DVT and PTS patients. Lower CIVIQ-20, and higher SF-36 scores, indicated a better QOL. Permanently occluded stents were described separately.
Results:
Out of 108 eligible patients, 73.1% filled out the questionnaires: n= 35 with acute DVT and n= 45 with PTS. In patients stented for PTS ≥ 5 years ago, all domains of QOL were similar compared with patients treated more recently (< 5 years ago), suggesting a durable effect on QOL (table 1). Long-term results were lacking for most patients with acute DVT (median 89 weeks, IQR: 150), and therefore were not described. Pain, physical and social domains of QOL were worse for PTS, but mental QOL was worse for acute DVT patients (table 2). Outcomes of QOL were also lower for permanently occluded stents (n= 4) compared to open stents (n= 75), with mean differences between 11.1 and 37.2 points on SF-36 domains, but statistical testing was omitted because of small sample sizes.
Conclusion:
For PTS patients with an open stent, quality of life seems to remain stable, even years after the initial procedure. The worst QOL was found for patients with occluded stents. Physical domains of QOL were worse for chronic PTS, but mental QOL was worse after stenting for acute DVT. Peri-procedural psychologic support in the acute phase of DVT may therefore be advised to improve QOL. Long-term QOL from future studies should confirm whether venous stenting is preferred in the acute and the chronic phase of DVT.
References:
1. Raskob GE, Angchaisuksiri P, Blanco AN, Buller H, Gallus A, Hunt BJ, et al. Thrombosis: a major contributor to global disease burden. Arterioscler Thromb Vasc Biol. 2014;34(11):2363-71. 2. Galanaud JP, Monreal M, Kahn SR. Epidemiology of the post-thrombotic syndrome. Thromb Res. 2018;164:100-9. 3. Rossi FH, Kambara AM, Izukawa NM, Rodrigues TO, Rossi CB, Sousa AG, et al. Randomized double-blinded study comparing medical treatment versus iliac vein stenting in chronic venous disease. J Vasc Surg Venous Lymphat Disord. 2018;6(2):183-91. 4. Catarinella FS, Nieman FH, de Wolf MA, Toonder IM, de Graaf R, Wittens CH. Quality-of-life in interventionally treated patients with post-thrombotic syndrome. Phlebology. 2015;30(1 Suppl):89-94.
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