Quality-of-life in interventionally treated patients with post-thrombotic syndrome.
BACKGROUND
New developments in the treatment of complex deep venous disease have become available in the last decade. Besides analysing patencies as a surrogate outcome for these treatments we analysed the Quality-of-Life (QoL) changes for successful and failed deep venous treatments.


METHODS
Patients with proven venous occlusive disease, referred to our department of Venous Surgery at the Maastricht University Medical Centre, were included. After inclusion patients were treated by percutaneous transluminal angioplasty and stenting and when indicated endophlebectomy with an arteriovenous fistula. QoL was assessed with the disease specific VEINES-QOL/Sym and the generic Short-Form (SF)-36 questionnaires preoperatively at baseline and post-operatively after 3, 12 and 24 months.


RESULTS
One hundred fifty-three interventions were analysed, showing a primary, assisted primary and secondary patency of respectively 65%, 78% and 89% at 24 months. The VEINES-QOL and Sym scores improved at 3, 12 and 24 months. The overall improvement at 24 months is 22.7 for QoL and 18.18 for Sym with respective p values of 0.013 and 0.016. The improvement of the VEINES-QOL and Sym scores after a successful (patent) treatment remained highly significant (QoL: p < 0.001, Sym: p = 0.004). Also the generic QoL (Short-Form 36v2) shows significant improvement after 12 months for physical functioning (p = 0.004) and role physical (p = 0.004) scales.


CONCLUSIONS
The overall patencies of interventions for deep venous pathology are exceptionally good after two years. Concomitantly the VEINES-Sym and VEINES-QOL scores improve significantly for 3, 12, and 24 months when compared to the baseline (T0) after treatment. Successful interventions showed, as expected, a significant greater QoL improvement between T0 and T3, T12, T24 for both VEINES-QOL and VEINES-Sym scores when compared to the failed interventions. The one-year linear improvement of two SF-36 scales (PF and RP) is also significant.
Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands fabio@catarinella.nl.
F S
FS
Catarinella
Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands.
F H M
FH
Nieman
Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.
M A F
MA
de Wolf
Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.
I M
IM
Toonder
Department of Radiology, Maastricht University Medical Centre, Maastricht, the Netherlands.
R
R
de Graaf
Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands Department of Vascular Surgery, Universitäts Klinikum, Aachen, Germany.
C H A
CH
Wittens
D001163:Arteriovenous Anastomosis; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D054070:Postthrombotic Syndrome / Q000503:physiopathology* / Q000601:surgery*; D011788:Quality of Life
Maastricht; Maastricht University Medical Centre; Quality-of-life; deep venous obstruction; percutaneous transluminal angioplasty; post-thrombotic syndrome; venous stent