Influence of time from symptom to treatment on quality of life in primary subclavian vein thrombosis

IntroductionPrimary subclavian vein thrombosis (PSVT) is a rare (incidence 2/100,000) disease affecting predominantly young and physically active persons. A treatment protocol advocated by several studies includes catheter directed thrombolysis (CDT) within 14 days followed by decompressive surgery (TOD). A main purpose of this treatment is to prevent long term complications in form of Post-Thrombotic Syndrome (PTS), which manifests as reduced quality of life (QoL), assessed by the Disability of the Arm, Shoulder and Hand (DASH) score. CDT is rarely successful if started later than 14 days after the onset of symptoms. However, it is not known how a delay within the timespan of two weeks affects QoL in PSVT patients. AimsTo investigate if there is a significant difference in QoL between PSVT patients receiving early treatment with CDT compared to those receiving delayed CDT. Material and MethodsDASH score from 65 PSVT patients in Stockholm 2006-2018 was evaluated pretreatment and at one year follow up. Patients were divided into two groups depending on time from symptom to treatment with CDT. Early treatment group (0-3 days to CDT) was compared to delayed treatment group (4-14 days to CDT). Chi2 test was used to analyze differences in patient characteristics and Mann-Whitney-U test was used to identify any differences between the groups. ResultsNo significant differences were detected (p=0.497) ConclusionsNo indication that treatment within 3 days from PSVT symptom onset is superior to treatment after 4-14 days was found. Because of the non-randomized design and small population, further studies are needed.