Analysis of the of shunts’ patency after arterial reconstruction of the femoral-popliteal-tibial segments

The problem of improving the shunts' patency after arterial reconstructions of the femoral-popliteal-tibial segment long occupy the minds of vascular surgeons. However, a model that takes into account the most significant risk factors and allows us to determine the optimal followup period of such patients has not yet been proposed. Aim: A statistical ЖУРНАЛ НАУКОВИЙ ОГЛЯД № 6(59), 2019 analysis of the risk factors for occlusion of such shunts and the development of a reliable prognostic model based on the regression function. Materials and methods: A retrospective analysis of 136 cases of femoral-popliteal (FPS) and femoral-tibial shunts (FTS) of atherosclerotic genesis was made at the Department of Vascular Surgery of the Orel Regional Clinical Hospital in the period from 2008 to 2018. Statistical data analysis was performed using binary logistic regression and building a ROC curve using IBM SPSS Statistics 22. Results: Using the binary logistic regression method, a reliable model was developed to predict the likelihood of primary patency of such shunts by the values of signs: degree of ischemia, superficil femoral artery patency, history of diabetes mellitus, pre-operative INR data and hemoglobin level. The model has a high prognostic value, specificity, sensitivity and information. Conclusion: Patients with occlusion risk factors proposed in the developed model should first be given periodic preventive examination of a vascular surgeon 1, 3, 6 months, 1 year and 2 years after surgery with an ultrasound of the arteries of the lower extremities and shunt and also advise such patients to undergo a study of the level of leukocytes and blood platelets.