Indian Journal of Vascular and Endovascular Surgery (Jan 2021)

Assessment of quality of life between patients undergoing pharmacomechanical catheter-directed thrombolysis versus conservative management with iliofemoro-popliteal deep-vein thrombosis

  • S V R Krishna Yeramsetti,
  • Shrikant Pandurang Ghanwat,
  • Tapish Sahu,
  • Virender Sheorain,
  • Tarun Grover,
  • Rajiv Parakh

DOI
https://doi.org/10.4103/ijves.ijves_147_20
Journal volume & issue
Vol. 8, no. 5
pp. 36 – 40

Abstract

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Background: Pharmacomechanical catheter-directed thrombolysis (PCDT) has revolutionized the treatment of acute deep-vein thrombosis (DVT). Assessment and comparison of quality of life (QOL) in patients treated with anticoagulation alone and PCDT need to be elaborated more in the context of better management of patients. The objective of this study was to compare and assess QOL using health-related QOL (HRQOL) which includes short form-36 (SF-36) and VIENES QOL/sym scoring systems in anticoagulation alone group and patients treated with PCDT. Methods: There were 130 consecutive patients presenting to our department with acute iliofemoro-popliteal DVT (IFPDVT) with <2 weeks duration treated between April 2018 and April 2019 were included in the study. Sixty-five patients received anticoagulation alone and the other 65 patients received PCDT along with anticoagulation. Patients were assessed at baseline, the 1st month, and the 6th month in terms of QOL, deep venous patency (DVP), and deep venous reflux (DVR). Results: There was a statistically significant difference between the two groups in terms of QOL at 1st and 6 months. Mean physical component score and mental component score were statistically significantly better in PCDT than the conservative group at 1 and 6 months, respectively (P = 0.001). Mean venous insufficiency epidemiological and economic study (VEINES) QOL and VEINES SYM scores were significantly better in PCDT group than conservative group at 1 and 6 months, respectively (P = 0.001). Conclusion: QOL, DVP, and DVR are significantly better when PCDT is offered as an initial option when compared to anticoagulation alone. HRQOL (SF 36 and VEINESQOL/SYM score) should be considered as an outcome measure in clinical studies on patients with IFPDVT along with other comparison parameters with respect to QOL. However, long-term follow-up is required to establish the superiority of PCDT in IFPDVT patients.

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