Qureshi Adnan I, Saleem Muhammad A, Naseem Nishath, Wallery Shawn S
Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA.
University of Illinois and Mercyhealth, Rockford, IL, USA.
J Vasc Interv Neurol. 2018 Jun;10(1):7-13.
Patients with vertebral, subclavian, or innominate arterial stenosis can present with recurrent symptoms that can adversely affect the quality of life (QOL). We aimed at determining the short-term effects of endovascular treatment (ET) on QOL in these patients.
European Quality of Life Five Dimension Scale (EQ-5D) utility index and visual analog scale (VAS) were ascertained before and within one month of ET in patients with vertebral, subclavian, or innominate arterial stenosis with recurrent episodes of vertigo, near syncope, and/or ataxia. The EQ-5D utility scores were derived from responses to five questions on EQ-5D questionnaire (-0.109 for the least to 1 for most favorable). The EQ-5D VAS score was obtained by subject's indication of his/her health state on a scale of 0 (worst) to 100 (best).
Angioplasty and/or stent placement was performed in 10 patients for stenosis in extracranial vertebral ( = 6), intracranial vertebral ( = 1), subclavian ( = 2), or innominate artery ( = 1). There was a significant reduction in preprocedure severity [mean ± standard deviation (SD)] of stenosis compared with postprocedure severity (79.9 ± 14.05% vs. 26.4 ± 37.7%, < 0.001). There was a significant improvement in mean values of EQ-5D VAS postprocedure compared with preprocedure values (72 vs. 57.5, = 0.018). Minimal important difference (improvement of at least 0.074) on EQ-5D utility index and on VAS (improvement ≥ 10 points) was reported by five and six of 10 patients, respectively.
Improvement in QOL appears to be an important measure of effectiveness of ET in patients with vertebral, subclavian, or innominate arterial stenosis with recurrent episodes of vertigo, near syncope, and/or ataxia.
患有椎动脉、锁骨下动脉或无名动脉狭窄的患者可能会出现反复出现的症状，这些症状会对生活质量（QOL）产生不利影响。我们旨在确定血管内治疗（ET）对这些患者生活质量的短期影响。
在患有椎动脉、锁骨下动脉或无名动脉狭窄且反复出现眩晕、接近晕厥和/或共济失调的患者中，于血管内治疗前及治疗后1个月内确定欧洲五维健康量表（EQ-5D）效用指数和视觉模拟量表（VAS）。EQ-5D效用得分来自对EQ-5D问卷中五个问题的回答（从最不利的-0.109到最有利的1）。EQ-5D VAS得分是通过受试者在0（最差）至100（最佳）的量表上表明其健康状态获得的。
对10例患者进行了血管成形术和/或支架置入术，分别用于治疗颅外椎动脉（n = 6）、颅内椎动脉（n = 1）、锁骨下动脉（n = 2）或无名动脉（n = 1）狭窄。与术后狭窄严重程度相比，术前狭窄严重程度[平均值±标准差（SD）]显著降低（79.9±14.05%对26.4±37.7%，P < 0.001）。与术前值相比，术后EQ-5D VAS平均值有显著改善（72对57.5，P = 0.018）。10例患者中分别有5例和6例报告EQ-5D效用指数有最小重要差异（至少改善0.074）和VAS有最小重要差异（改善≥10分）。
生活质量的改善似乎是血管内治疗对患有椎动脉、锁骨下动脉或无名动脉狭窄且反复出现眩晕、接近晕厥和/或共济失调患者有效性的一项重要指标。
