Single Center 5-year analysis of Survival and QoL of Catheter Directed Therapy of High and Intermediate risk PE

Sunday, March 5, 2023

4:03 PM – 4:12 PM

Location: Phoenix Convention Center, 226ABC

Presenting Author(s)

GW

Gregory J. Woodhead, MD, PhD

Assistant Professor, Interventional Radiology
University of Arizona

Disclosure(s): No relevant disclosure to display

Author/Co-author(s)

AK

Abdul Khan, MD

Resident Physician
University of Arizona
MK

Michael Kendall, MD

Attending Physician
University of Arizona
LM

Lawrence Matiski, BS

Medical Student
University of Arizona

Disclosure(s):

Gregory J. Woodhead, MD, PhD: No relevant disclosure to display

Purpose:

The treatment for intermediate risk pulmonary embolism (PE) by catheter-directed treatment (CDT) requires long term analysis of quality of life, functional status, and survival analysis. The purpose of this study was to analyze outcomes of CDT regarding long term survival and quality of life with comparison to a matched cohort on patients treated with anticoagulation.

Materials and Methods:

A retrospective study approved by the institutional review board to investigate patient outcomes of catheter-based therapies of intermediate risk PEs in comparison to patients treated solely with anticoagulation (AC). Data tracked over five years was used to perform survival analysis and create Kaplan Meier curves using SPSS. Additionally, a small set of patients were recruited to complete Pem-QoL surveys for quality of life as well as perform 6-minute walk tests (6MWT).

Results:

Over five years, our analysis included 93 submassive patients. There were 36 treated with CDT plus anticoagulation and 57 patients treated with anticoagulation alone. The CDT group survival probability decreased to 75% over five years, while the survival probability of the anticoagulation group decreased to 82%. A long rank test demonstrated no statistically significance difference regarding survival probability (p=0.78). Additionally, 15 catheter directed therapy patients and 5 anticoagulation patients completed PEmbQoL surveys as well as 6MWTs. Statistically significant differences were noted in QoL subscales included activities of daily living (ADLs) and emotional complaints (EC), p < 0.05. Distance traveled for 6MWT was not statistically significant (CDT mean 394 meters, AC mean 374 meters, p = 0.3).

Conclusion:

Analysis of quality-of-life survey using PEmbQoL demonstrates statistically significant differences in ADLs and EC. Survival analysis demonstrates similar survival probabilities over five years. No statistically significant differences in 6MWT seen in a small sample size of comparison. Further investigation is prompted given our small sample size. As patients are continued to be followed for 10 years and multicenter studies are developed tracking long term data, more accurate analysis of survival, quality of life and functional status can be performed.