Background: Medial Arterial Calcification (MAC) of the foot is a predictor of cardiovascular morbidity and mortality in diabetics. The MAC score is a tool to describe with plain radiographs the burden of inframalleolar arterial calcification. 

Objective: To determine the degree of association between MAC and the risk of major amputation. 

Methods: Retrospective longitudinal cohort study analyzing radiographs of extremities with diabetic foot from March 1, 2021 to July 31, 2022. They were classified according to their MAC score and interventions performed at 6 months were recorded; chi-square test and relative risk test were performed to determine significant association between severe MAC and major amputation. 

Results: Out of 102 extremities studied, 37 patients (35.9%) had severe MAC; 28 suffered major amputation, with a significant risk estimation (RR: 3.28, CI: 95% 1.985-5.428). 

Conclusion: Severe MAC in patients with diabetic foot increases 3.2 times the risk of a major amputation during the 6 months following the appearance of an ulcer.

Luis David Gonzalez is an angiologist and vascular surgeon recently graduated from the University of Guadalajara in Jalisco, Mexico. He is currently in private practice at the vascular clinic “Venart” in the city of Tuxtla Gutierrez in Chiapas Mexico. His practice focuses on the integral treatment of diabetic foot and limb salvage.