Ab1471 prospective Follow-Up of the Post-Thrombotic Syndrome Development Risk in Patients With Vascular Behçet’s Disease

Abstract

BackgroundDeep vein thrombosis (DVT) is the most common form of vascular involvement in Behçet’s disease (BD). Post-thrombotic syndrome (PTS) refers to the symptoms and signs of chronic venous insufficiency following DVT. It develops within the first 2 years in more than half of the patients after acute DVT [1].ObjectivesIn this prospective study, we aimed to evaluate the risk of PTS development after DVT and the factors affecting the development and severity of PTS in BD patients.MethodsBD patients (n=18) with acute DVT and were followed in 3 tertiary rheumatology centers were included in the study. Patients are evaluated for PTS presence during acute DVT, 6-12. months and then annually. Villalta scoring with a total score of >4 or presence of venous ulcer was defined as PTS. PTS was classified as mild if the score was between 5-9, moderate between 10-14, and presence of >14/venous ulcers as severe. Venous Damage Score (VDS) was used to evaluate the effect of venous disease on work productivity and Venous Clinical Severity Score (VCSS) for symptom severity.ResultsThe clinical features of the 18 patients included in the study are shown in Table 1. Major-organ involvement was present in 12 patients (pulmonary involvement in 7 (39%), ocular involvement in 5 (28%), arthritis in 3 (13%), neurobehçet and enterobehçet each in 1 patient). Steroid and IS treatment was given to all patients after an acute DVT attack. Additional anticoagulant (AC) treatment was chosen in 16 of the patients. Patients were followed up for a median 23.2 (6-40) months after DVT. The number of patients followed for at least 1 year after an acute DVT attack was 15, and the median follow-up period was 26 (12-40) months. The median duration of AC use in patients who received AC treatment in the follow-up was 6 (0-12) months. PTS developed in 5 (33%) of 15 patients during follow-up. The baseline, 6th and 12th month course of Villalta, VCSS, and VDS scores are shown in figure 1.ConclusionIn this prospective follow-up after an acute DVT attack 33% of BD patients developed PTS within 1 year. In our previous retrospective study, 62% of 205 patients, half of whom received AK, developed PTS during follow-up [2]. Despite the limitations of our study, such as the low number of patients and the short follow-up period, AC treatment in all patients (except 1) may have influenced a lower PTS development in the prospective follow-up compared to the retrospective data.References[1]Baldwin MJ et al. J Thromb Haemost. 2013 May;11(5):795-805.[2]Aksoy Aet al. J Vasc Surg Venous Lymphat Disord 2021; 9:1451.Table 1.Characteristics of Study PatientsClinical manifestationsSS/StdAge, average33.56 (9.62)Female/male, n(%)4/14 (%22.2)Family history (BD)3 (%16.7)Oral ulcers16 (%88.9)Genital ulcers9 (%50)Papulopustular lesions(%61.1)erythema nodosum6 (%33.3)Pulmonary involvement7 (%38.9)Articular involvement3 (%16.6)Neurological involvement1 (%5.6)Ocular disease5 (%27.8)Gastrointestinal involvement1 (%5.6)Figure 1.Acknowledgements:NIL.Disclosure of InterestsNone Declared.