Journal of vascular and interventional radiology : JVIR · 2026
Quality of Life Following Endovascular Treatment of Proximal Lower Limb Deep Vein Thrombosis: A Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Wardak Yusuf H, Chung Yun-En, Maingard Julian, Asadi Hamed, Kok Hong Kuan, Mitreski Goran
Аннотация
PURPOSE: To assess the quality-of-life outcomes of endovascular management versus anticoagulation alone in patients with proximal lower limb deep vein thrombosis (external iliac, common femoral, deep femoral, femoral, and/or popliteal veins).
MATERIALS AND METHODS: MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov were searched to February 2025. Primary outcomes included postthrombotic syndrome (PTS) incidence; mild, moderate, and severe PTS incidence; Villalta score; Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms questionnaire score; and EQ5D questionnaire score. Quality-of-life outcomes not fit for meta-analysis were extracted for narrative synthesis.
RESULTS: Four randomized controlled trials and 1 retrospective cohort study were included for meta-analysis, totaling 1,484 patients. Three retrospective cohort studies, totaling 391 patients, were additionally included for narrative synthesis. Endovascular patients had reduced rates of PTS at 6 months (relative risk [RR], 0.61; 95% CI, 0.38-0.98; number needed to treat [NNT], 8.1), 24 months (RR, 0.80; 95% CI, 0.66-0.98; NNT, 11.9), and long term (>24 months [RR, 0.54; 95% CI, 0.36-0.81; NNT, 3.9]). Endovascular patients also had a reduced rate of mild PTS (RR, 0.50; 95% CI, 0.32-0.79; NNT, 5.3) and a lower Villalta score at 12 months (mean difference, -1.16; 95% CI, -1.19 to -1.13). Narrative synthesis revealed improvements in Health Utilities Index, physical role functioning, stigma, health distress, overall symptoms, and subjective improvement in endovascular patients.
CONCLUSIONS: Endovascular treatment reduces PTS and demonstrates a trend in improving long-term quality-of-life outcomes. Although high-quality data for quality-of-life outcomes remain limited, positive findings across diverse measures suggest meaningful benefits. Future studies should include standardized quality-of-life outcomes at defined follow-up points.
MATERIALS AND METHODS: MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov were searched to February 2025. Primary outcomes included postthrombotic syndrome (PTS) incidence; mild, moderate, and severe PTS incidence; Villalta score; Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms questionnaire score; and EQ5D questionnaire score. Quality-of-life outcomes not fit for meta-analysis were extracted for narrative synthesis.
RESULTS: Four randomized controlled trials and 1 retrospective cohort study were included for meta-analysis, totaling 1,484 patients. Three retrospective cohort studies, totaling 391 patients, were additionally included for narrative synthesis. Endovascular patients had reduced rates of PTS at 6 months (relative risk [RR], 0.61; 95% CI, 0.38-0.98; number needed to treat [NNT], 8.1), 24 months (RR, 0.80; 95% CI, 0.66-0.98; NNT, 11.9), and long term (>24 months [RR, 0.54; 95% CI, 0.36-0.81; NNT, 3.9]). Endovascular patients also had a reduced rate of mild PTS (RR, 0.50; 95% CI, 0.32-0.79; NNT, 5.3) and a lower Villalta score at 12 months (mean difference, -1.16; 95% CI, -1.19 to -1.13). Narrative synthesis revealed improvements in Health Utilities Index, physical role functioning, stigma, health distress, overall symptoms, and subjective improvement in endovascular patients.
CONCLUSIONS: Endovascular treatment reduces PTS and demonstrates a trend in improving long-term quality-of-life outcomes. Although high-quality data for quality-of-life outcomes remain limited, positive findings across diverse measures suggest meaningful benefits. Future studies should include standardized quality-of-life outcomes at defined follow-up points.