title: Postthrombotic syndrome and quality of life in patients with iliofemoral venous thrombosis treated with catheter-directed thrombolysis.
abstract: BACKGROUND
  Postthrombotic syndrome (PTS) is a common complication after iliofemoral venous thrombosis, often resulting in poor quality of life (QOL) among the affected patients. This study assessed development of PTS and its effect on QOL among patients treated for iliofemoral venous thrombosis by catheter-directed thrombolysis.
  
  
  METHODS
  Patients admitted with an iliofemoral venous thrombosis and treated with catheter-directed thrombolysis at Gentofte University Hospital from 1999 to 2008 were invited to participate. Duplex ultrasound imaging was used to assess venous patency and valve function. Each patient completed the generic Short-Form 36-item (SF-36) health survey assessment, producing physical component (PCS) and mental component summary (MCS) scores, and the disease-specific Venous Insufficiency Epidemiological and Economic Study (VEINES)-Quality of Life (QOL)/Symptoms (Sym), questionnaires to assess QOL. PTS was assessed using the Villalta scale.
  
  
  RESULTS
  The study included 109 patients. Median follow-up was 71 months. PTS developed in 18 patients (16.5%) and of those, initial thrombolysis was successful in 13. Patients with PTS had significantly worse mean ± standard deviation scores than patients without PTS on VEINES-QOL (34.2 ± 9.6 vs 53.1 ± 6.6; P < .0001), VEINES-Sym (34.0 ± 8.8 vs 53.2 ± 6.6; P < .0001), SF-36 MCS (44.2 ± 15.5 vs 52.3 ± 11.0; P = .005), and SF-36 PCS (42.3 ± 9.1 vs 53.5 ± 7.8; P < .0001) subscales. Patients with reflux or chronic occlusions, or both, had significantly lower mean ± SD scores than patients with patent veins without reflux on VEINES-QOL (43.5 ± 14.3 vs 51.0 ± 8.8; P = .044) and SF-36 PCS (47.2 ± 10.9 vs 52.4 ± 8.5; P = .049) scales.
  
  
  CONCLUSIONS
  PTS was associated with worse QOL, although only a few patients developed PTS after catheter-directed thrombolysis of iliofemoral venous thrombosis. Patients with patent veins and sufficient valves have higher QOL scores than patients with reflux and occluded veins.
authors.affiliation: Department of Vascular Surgery, Rigshospitalet and Gentofte, University of Copenhagen, Copenhagen, Denmark. rbroholm@dadlnet.dk
authors.forename: Rikke
authors.initials: R
authors.lastname: Broholm
authors.forename: Henrik
authors.initials: H
authors.lastname: Sillesen
authors.forename: Mogens Trab
authors.initials: MT
authors.lastname: Damsgaard
authors.forename: Maja
authors.initials: M
authors.lastname: Jørgensen
authors.forename: Sven
authors.initials: S
authors.lastname: Just
authors.forename: Leif Panduro
authors.initials: LP
authors.lastname: Jensen
authors.forename: Niels
authors.initials: N
authors.lastname: Bækgaard
mesh_terms: D000293:Adolescent; D000328:Adult; D057785:Catheters; D005260:Female; D005268:Femoral Vein; D006801:Humans; D007084:Iliac Vein; D008297:Male; D008875:Middle Aged; D054070:Postthrombotic Syndrome / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D015912:Thrombolytic Therapy / Q000295:instrumentation; D020246:Venous Thrombosis / Q000150:complications* / Q000188:drug therapy*; D055815:Young Adult