Comparison of Pharmacomechanical Catheter-Directed Thrombolysis versus Catheter-Directed Thrombolysis for the Treatment of Acute Iliofemoral Deep Vein Thrombosis: Measures of Long-Term Clinical Outcome and Quality of Life

Autor: Jingfan Yu, Xin Hong, Wenbin Ding, Tianan Huang, Yu Yin, Zhuo Chen, Yonghai Jin
Rok vydání: 2022
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
Chronic venous insufficiency
medicine.medical_treatment
030204 cardiovascular system & hematology
Iliac Vein
Severity of Illness Index
030218 nuclear medicine & medical imaging
Postthrombotic Syndrome
03 medical and health sciences
0302 clinical medicine
Quality of life
Fibrinolytic Agents
Catheterization
Peripheral
Medicine
Humans
Thrombolytic Therapy
Vascular Patency
Aged
Retrospective Studies
Venous Thrombosis
business.industry
Incidence (epidemiology)
Incidence
Retrospective cohort study
General Medicine
Thrombolysis
Odds ratio
Femoral Vein
Middle Aged
medicine.disease
Confidence interval
Surgery
Treatment Outcome
Acute Disease
Quality of Life
Administration
Intravenous
Female
business
Cardiology and Cardiovascular Medicine
Post-thrombotic syndrome
Zdroj: Journal of Vascular Surgery: Venous and Lymphatic Disorders. 10:283
ISSN: 2213-333X
DOI: 10.1016/j.jvsv.2021.10.004
Popis: Background We studied the occurrence of post-thrombotic syndrome (PTS) in patients with either Pharmacomechanical Catheter-Directed Thrombolysis (hereafter “pharmacomechanical thrombolysis”; PT) or Catheter-Directed Thrombolysis (CDT) for the treatment of acute iliofemoral deep vein thrombosis (DVT). Methods This retrospective study of data archived between September 2013 and September 2015 was surveyed. Two separate patient populations were identified and analyzed: patients were separated into PT group or CDT group. For up to 5 years post-treatment, the incidence, severity of PTS, and chronic venous insufficiency questionnaire (CIVIQ) score difference were compared. Results The study identified 131 patients divided into PT group (65) and CDT group (66). Within the 5-year follow-up period, there was no significant difference in the incidence of PTS (45.0% PT vs. 57.6% CDT; odds ratio (OR) = 0.602; 95% confidence interval (CI), 0.291–1.242; P = 0.201), but there was reduced severe PTS in the PT group (Villalta scale ≥15 or ulcer:11.7% PT vs. 27.1% CDT; OR 0.355; 95%CI 0.134–0.941, P = 0.039; and Venous Clinical Severity Score (VCSS) ≥8: 13.3%PT vs. 28.8% CDT; OR 0.380; 95% CI 0.149–0.967, P = 0.045). There was also a larger improvement of venous disease-specific quality of life (QOL) in the PT group at 5 years [(62.89 ± 14.19) vs (56.39 ±15.62), P = 0.036] compared to the CDT group. Conclusion In patients with acute iliofemoral DVT treated with PT, PT significantly reduced PTS severity scores, and resulted in greater improvement in venous disease-specific QOL. However, the incidence of was not significantly different from that measured in the CDT.
Databáze: OpenAIRE
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