Effect of Endovascular Treatment on Quality of Life in Patients with Recurrent Symptoms Associated with Vertebral, Subclavian, or Innominate Arterial Stenosis.

Abstract

Background: 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.

Methods: 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).

Results: Angioplasty and/or stent placement was performed in 10 patients for stenosis in extracranial vertebral (n = 6), intracranial vertebral (n = 1), subclavian (n = 2), or innominate artery (n = 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%, p < 0.001). There was a significant improvement in mean values of EQ-5D VAS postprocedure compared with preprocedure values (72 vs. 57.5, p = 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.

Conclusions: 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.