Ischaemia of a femoral stump in short- and long-term periods after limb amputation

Zoloev D.G.^1,3, Makarov D.N.², Koval O.A.², Zoloev G.K.^1,3

1) Novokuznetsk State Institute of Advanced Training of Physicians, Branch of the Russian Medical Academy of Continuing Professional Education under the RF Ministry of Public Health,
2) Novokuznetsk Scientific and Practical Centre of Medical and Social Examination and Rehabilitation of Invalids under the RF Ministry of Labour and Social Protection,
3) Clinic "Grand Medica", Novokuznetsk, Russia

The authors retrospectively analysed medical case histories of 287 patients subjected to femoral amputations over the period from January 1, 1998 to December 31, 2013. The studied parameters were as follows: the frequency of and risk factors for femoral stump ischaemia, as well as the effect on patients’ survival after femoral amputation.

Amongst 156 patients having endured transfemoral truncation of the limb performed as the first amputation, early femoral stump ischaemia (EFSI) within 3 postoperative months was found to have occurred in 43 (27.6%) patients, whereas amongst 127 patients first subjected to amputation of the crus and then to femoral truncation it occurred in 15 (13.2%) cases; p<0.05. The incidence rate of late femoral stump ischaemia (LFSI) was virtually similar in both groups, amounting to 5.8% (9 of 156) and 5.5% (7 of 127), respectively; p>0.05.

The survival rate for patients without stump ischaemia at 12 months after amputation amounted to 79.4%, for those with EFSI to 50.0% (p=0.00928), and for those with LFSI to 71.4% (p=0.22576), whereas by the end of a 5-year follow up period these values appeared to equal 49.2%, 32.1% (p=0.13225) and 7.1% (p=0.01385), respectively.

The obtained findings demonstrated that the risk factors for EFSI were as follows: the presence of a femoral stump on the contralateral side, grade III ischaemia, and proximal localization of the lesion of the arterial bed (odds ratio 3.3, 2.7 and 3.8, respectively); a risk factor for LFSI was the presence of a femoral stump on the contralateral side (odds ratio 6.0).

KEY WORDS: atherosclerosis, lower limb ischaemia, amputation, femoral stump ischaemia, risk factors, survival.

P. 121

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