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

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 1-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 5 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 pre-procedure severity (mean ±SD) of stenosis compared with post-procedure severity (79.9±14.05% versus 26.4±37.7%, p<0.001). There was a significant improvement in mean values of EQ-5D VAS post-procedure compared with pre-procedure values (72 versus 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 5 and 6 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.