Background/Purpose:

Vascular involvement is seen in about one third of patients with Behçet Disease(BD). DVT(deep venous thrombosis) is the most common form of vascular Behçet Disease(VBD).Post-thrombotic syndrome(PTS) developing after a thrombotic event in lower extremity is one of the major complications of DVT and affects negatively patients’quality of life.In this study, we aimed to assess the presence,severity and risk factors of PTS and venous disease spesific quality of life in VBD.

Methods:

This study included 96 patients with BD (Female/Male:18/78, mean age: 38.8±8.74 years) having history of DVT from 3 tertiary Rheumatology centers in Turkey.Villalta scale was used to assess PTS.According to scale;PTS is present if score >4 and degree of PTS mild,moderate and severe if score 5-9,10-14,>14 respectively.The Venous Disability Score(VDS) and the Venous Clinical Severity Score(VCSS) were used for the assessment of venous disease. All patients were assessed with color Doppler ultrasonography(US) by experienced radiologists within 1 weeks following the clinical examination.In each patient, a total of 16superficial and deep veins in both legs were assessed for the presence or absence of obstruction,recanalization,reflux and collaterals.

Results:

When vascular involvement developed, mean age was 32.7±8.65.Venous assessment was done after 6(0-26)years first vascular event.During venous assessment, median disease duration was 9(0-34)years.Eighty(84.2%) patients were under ımmunsupressive(IS) treatment and 13 of these patients were under anticoagulation treatment in addition to ISs. Median IS time 37.5(1-256);anticoagulation time 12(1-156)months. PTS was present in 57(61.3%) out of 93 patients and severe PTS was present in 19(19.8%)patients.There was no association between presence of PTS and sex, age during DVT, compression stocking tretament usage, presence of relaps, duration of trombosis.There was no difference between patients with or without anticoagulant usage regarding PTS presence (p=0.817) and also there is no difference at duration of IS and AC treatment between patients with or without PTS .Doppler US examination shows no abnormalities at 10 (10.6%) patients, 5(50%)of these patients had PTS. Bilateral leg vessel involvement was present in 31(31.4%)patients.Fourty(47.6%) patients had both upper and lower leg vessel involvement.But we didn’t find any associaton with PTS presence and doppler US findings such as bilateral involvement, upper and lower leg vessel involvement, reflux or trombosis at any vessel in the affected leg.

When VBD patients with and without PTS were compared, quality of life(VEINES-QoL/Sym) and VCSS were significantly worse. The Behçet Syndrome Activity Score was also significantly higher in patients with PTS

Conclusion:

We found that PTS develops in more than half of the patients with VBD during follow-up. We didn’t found any predictor factor for development of PTS.About one third of patient with PTS were severe PTS.Our results confirm that PTS is very frequent clinical problem for physicians treating VBD in daily practice.During management of patients with VBD, PTS should be taken into account as much as preventing vascular relapses.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-of-severity-and-risk-factors-of-post-thrombotic-syndrome-in-vascular-behcet-disease-muticentered-retrospective-study/