Guillen Kévin, Thony Frédéric, Del Giudice Costantino, Goyault Gilles, David Arthur, Douane Frédéric, Le Bras Yann, Monnin-Bares Valérie, Heautot Jean-François, Rousseau Hervé, Martinelli Thomas, Thouveny Francine, Barral Pierre-Antoine, Le Pennec Vincent, Chabrot Pascal, Rogopoulos André, Aho-Glélé Ludwig Serge, Sapoval Marc, Rodière Mathieu, Chevallier Olivier, Falvo Nicolas, Loffroy Romaric
Department of Interventional Radiology, CHU Dijon, 21000 Dijon, France.
Department of Interventional Radiology, CHU Grenoble, 38000 Grenoble, France.
Diagnostics (Basel). 2023 Jul 13;13(14):2357. doi: 10.3390/diagnostics13142357.
Excellent outcomes of angioplasty/stenting for the post-thrombotic syndrome (PTS) have been reported, notably regarding objective criteria in the vast French SFICV cohort. Differences may exist between patient-reported and objective outcomes. We investigated this possibility by using validated scales because significative correlations are discordant in the literature between patency and patient-reported characteristics. Patient-reported outcomes seem to be a more consistent tool than radiologic patency for the diagnosis and follow-up of patients displaying PTS. We retrospectively reviewed the Villalta scale and 20-item ChronIc Venous dIsease quality-of-life Questionnaire (CIVIQ-20) scores recorded after endovascular stenting for PTS at 14 centres in France in 2009-2019. We also collected patency rates, pre-operative post-thrombotic lesion severity, and the extent of stenting. We performed multivariate analyses to identify factors independently associated with improvements in each of the two scores. The 539 patients, including 324 women and 235 men, had a mean age of 44.7 years. The mean Villalta scale improvement was 7.0 ± 4.7 ( < 0.0001) and correlated with the thrombosis sequelae grade and time from thrombosis to stenting. The CIVIQ-20 score was available for 298 patients; the mean improvement was 19.2 ± 14.8 ( < 0.0001) and correlated with bilateral stenting, single thrombosis recurrence, and single stented segment. The objective gains demonstrated in earlier work after stenting were accompanied by patient-reported improvements. The factors associated with these improvements differed between the Villalta scale and the CIVIQ-20 score. These results proved that clinical follow-up with validated scores is gainful in patients treated for PTS thanks to a mini-invasive procedure.
血管成形术/支架置入术治疗血栓后综合征(PTS)已取得了良好的效果,尤其是在法国规模庞大的SFICV队列研究中的客观标准方面。患者报告的结果与客观结果之间可能存在差异。由于在文献中,通畅率与患者报告的特征之间的显著相关性并不一致,因此我们使用经过验证的量表来研究这种可能性。对于表现出PTS的患者,患者报告的结果似乎是比放射学通畅性更一致的诊断和随访工具。我们回顾性分析了2009年至2019年法国14个中心对PTS进行血管内支架置入术后记录的Villalta量表和20项慢性静脉疾病生活质量问卷(CIVIQ - 20)评分。我们还收集了通畅率、术前血栓后病变严重程度以及支架置入范围。我们进行了多因素分析,以确定与这两个评分各自改善独立相关的因素。539例患者,包括324名女性和235名男性,平均年龄为44.7岁。Villalta量表的平均改善为7.0±4.7(<0.0001),并与血栓形成后遗症分级以及从血栓形成到支架置入的时间相关。298例患者有CIVIQ - 20评分;平均改善为19.2±14.8(<0.0001),并与双侧支架置入、单次血栓复发以及单个支架置入节段相关。支架置入术后早期研究中显示的客观改善伴随着患者报告的改善。Villalta量表和CIVIQ - 20评分与这些改善相关的因素有所不同。这些结果证明,对于接受PTS治疗的患者,通过微创程序进行经过验证评分的临床随访是有益的。