Early Postoperative Outcomes in Patients with Peripheral Artery Disease Residing in Uranium Legacy-Affected Areas: A Comparative Study.

Background

The impact of long-term residence in uranium legacy-affected areas on surgical outcomes in patients with lower extremity artery disease (LEAD) remains insufficiently studied.

Objectives

This study aimed to compare early postoperative dynamics of chronic lower limb ischemia (CLLI) in patients with LEAD residing in uranium legacy-affected areas and those living outside the zone of potential technogenic exposure.

Methods

The study included 70 patients with LEAD (CLLI stages IIB-IV according to the Fontaine classification). The study group (n = 35) consisted of patients who had resided for at least 5 years within a radius of less than 20 km from uranium tailings storage facilities (Stepnogorsk area, Akmola region, Kazakhstan). The control group (n = 35) comprised patients with the same diagnosis living outside this zone.

Results

The distribution of Fontaine stages was compared between groups before surgery and at 1 month postoperatively. Statistical analysis was performed using Pearson's chi-squared test. Before surgery, no statistically significant intergroup differences were found in the distribution of CLLI stages (χ2 = 3.688, df = 2, and p = 0.158). At 1 month after surgery, the control group demonstrated significantly better regression of ischemia stages: mild stages (I-IIa) were observed in 51.4% of control patients versus 8.6% in the study group, while severe stages (III-IV) persisted in 62.8% of the study group versus 22.9% of the control group (χ2 = 17.547, df = 4, and p = 0.002). Complete regression to stage I occurred only in the control group (2 patients, 5.7%).

Conclusions

Patients with LEAD residing long-term in uranium legacy-affected areas showed less favorable early postoperative dynamics compared to patients living outside the zone of potential technogenic exposure. The observed association requires cautious interpretation, and further prospective studies with individual exposure assessment are warranted.