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Quality of life after pharmacomechanical catheter-directed thrombolysis for proximal deep vein thrombosis
- Source :
- J Vasc Surg Venous Lymphat Disord
- Publication Year :
- 2020
-
Abstract
- After deep venous thrombosis (DVT), many patients have impaired quality of life (QOL). We aimed to assess whether pharmacomechanical catheter-directed thrombolysis (PCDT) improves short-term or long-term QOL in patients with proximal DVT and whether QOL is related to extent of DVT.The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial was an assessor-blinded randomized trial that compared PCDT with no PCDT in patients with DVT of the femoral, common femoral, or iliac veins. QOL was assessed at baseline and 1 month, 6 months, 12 months, 18 months, and 24 months using the Venous Insufficiency Epidemiological and Economic Study on Quality of Life/Symptoms (VEINES-QOL/Sym) disease-specific QOL measure and the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary general QOL measures. Change in QOL scores from baseline to assessment time were compared in the PCDT and no PCDT treatment groups overall and in the iliofemoral DVT and femoral-popliteal DVT subgroups.Of 692 ATTRACT patients, 691 were analyzed (mean age, 53 years; 62% male; 57% iliofemoral DVT). VEINES-QOL change scores were greater (ie, better) in PCDT vs no PCDT from baseline to 1 month (difference, 5.7; P = .0006) and from baseline to 6 months (5.1; P = .0029) but not for other intervals. SF-36 PCS change scores were greater in PCDT vs no PCDT from baseline to 1 month (difference, 2.4; P = .01) but not for other intervals. Among iliofemoral DVT patients, VEINES-QOL change scores from baseline to all assessments were greater in the PCDT vs no PCDT group; this was statistically significant in the intention-to-treat analysis at 1 month (difference, 10.0; P .0001) and 6 months (8.8; P .0001) and in the per-protocol analysis at 18 months (difference, 5.8; P = .0086) and 24 months (difference, 6.6; P = .0067). SF-36 PCS change scores were greater in PCDT vs no PCDT from baseline to 1 month (difference, 3.2; P = .0010) but not for other intervals. In contrast, in femoral-popliteal DVT patients, change scores from baseline to all assessments were similar in the PCDT and no PCDT groups.Among patients with proximal DVT, PCDT leads to greater improvement in disease-specific QOL than no PCDT at 1 month and 6 months but not later. In patients with iliofemoral DVT, PCDT led to greater improvement in disease-specific QOL during 24 months.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Mechanical Thrombolysis
medicine.medical_treatment
Catheter directed thrombolysis
030204 cardiovascular system & hematology
Iliac Vein
Article
law.invention
03 medical and health sciences
0302 clinical medicine
Fibrinolytic Agents
Quality of life
Randomized controlled trial
law
Surveys and Questionnaires
Internal medicine
Epidemiology
Medicine
Humans
In patient
Thrombolytic Therapy
030212 general & internal medicine
cardiovascular diseases
Thrombus
Venous Thrombosis
business.industry
Thrombolysis
Femoral Vein
Middle Aged
medicine.disease
United States
humanities
3. Good health
Venous thrombosis
Treatment Outcome
Quality of Life
Female
Surgery
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- J Vasc Surg Venous Lymphat Disord
- Accession number :
- edsair.doi.dedup.....bccffdae023e9049907fbbd0669a6077