Health-related quality-of-life improvement using catheter-directed thrombolysis for iliofemoral deep venous thrombosis

Purpose
Catheter-directed thrombolysis (CDT) effectively eliminates thrombus in patients with iliofemoral deep vein thrombosis (DVT) with good patency and low complication rates. Thus, an effective measure of treatment success is the assessment of health-related quality of life (HRQOL). This study evaluates whether CDT for iliofemoral DVT is associated with improved HRQOL compared with standard anticoagulation (AC) treatment.
Patients and methods
Between January 2016 and June 2017, 33 (33 limbs) patients having acute iliofemoral DVT were allocated in two groups: group A (18 patients) received standard AC therapy alone and group B (15 patients) was managed with CDT. All patients were candidates for thrombolysis. Follow-up included clinical exanimation and ultrasound. Mean age was 32.6 years (19–57 years) in group A and 34.2 (20–53), in group B. The percentage of male and female was 38.8 and 61.2%, respectively, in group A and 33.3 and 66.4%, respectively, in group B. The venous clinical severity score and the modified Arabic version of the Chronic Venous Insufficiency Questionnaire 20 questionnaires were used to assess the quality of life and symptoms of post-thrombotic syndrome.
Results
Thrombus lysis was completed in 10/15 (66.6%) patients, partial in four (26.6%) patients, and not achieved in one (6.6%) patient. Successful CDT was followed by stent angioplasty in 33.3% (5/15) of the patients. There was significant difference between the two patient groups regarding Chronic Venous Insufficiency Questionnaire 20 questionnaire at 1 and 12 months, with value of 0.01. Moreover, venous clinical severity scores at 6 and 12 months were statistically different between the two groups, with values of 0.005 and 0.009, respectively.
Conclusion
CDT for the management of patients with iliofemoral DVT significantly improves HRQOL compared with similar patients treated with AC alone. Improved quality of life is related to successful thrombolysis.