Resumo

MAIA, Miguel; CRUZ, André; VIDOEDO, José  e  PINTO, João Almeida. Pos-thrombotic syndrome and quality of life in patients with ilio-femoral venous thrombosis. Angiol Cir Vasc [online]. 2014, vol.10, n.4, pp.173-179. ISSN 1646-706X.

Aim: Define post-thrombotic syndrome and quality of life in patients with a history of iliofemoral venous thrombosis, possible candidates for catheter-directed thrombolysis at time of diagnosis. Material and methods: Retrospective review of clinical records of patients diagnosed with iliofemoral venous thrombosis from January 1, 2009 to December 31, 2013. Selection of patients according to consensually accepted criteria for catheter-directed thrombolysis, at time of diagnosis. Patients were summoned for clinical interview, venous ultrasound examination of the lower limbs and filling of the Villalta, the SF-36 and the VEINES-QOL/Sym questionnaires. Results: In Centro Hospitalar do Tâmega e Sousa, from January 1, 2009 to December 31, 2013, 369 patients with deep venous thrombosis of the lower limbs were observed. Of these, 39 involved the ilio-femoral veins, in patients potentially candidates for catheter-directed thrombolysis. 28 patients were evaluated, 85.7% female. 64% of patients regularly wore elastic stockings. 40% of patients had a thrombophilia. Over 80% showed changes in the ultrasound examination, 46% had venous occlusion and 36% ilio-femoral reflux. 21% of patients had femoral-popliteal reflux. About 90% of patients showed post-thrombotic syndrome, being severe in 18%. The overall quality of life, represented by the general state of health, was classified as poor in 43% of patients. The vitality and mental health were the most adversely affected domains. In the statistical analysis, patients with worse outcomes in the questionnaires of quality of life were the ones with post-thrombotic syndrome, the women, patients with DVT in the right leg, with reflux = 2 seconds, with distal reflux to the segment involved by the thrombosis and when the DVT was diagnosed in the first month after a surgical procedure. Conclusion: The patients of this study, with ilio-femoral venous thrombosis, had a high frequency of post-thrombotic syndrome and a significant reduction in the quality of life. A subset of patients experienced worse outcomes. These results suggest that an invasive alternative should be considered in the initial treatment of proximal DVT. However, additional data are needed to precisely define the influence of catheter-directed thrombolysis in the quality of life of these patients.

Palavras-chave : Ilio-femoral venous thrombosis; Catheter-directed thrombolysis; Quality of life.