{
  "abstract": "Background: Healing after transmetatarsal amputation (TMA) depends on adequate tissue perfusion. Revascularization prior to minor amputation improves amputation-free survival, limb preservation, and wound healing in patients with ischemic wounds. However, the optimal interval between revascularization and amputation remains unclear.\n\nMethods: The TriNetX real-world clinical data platform was used to identify patients with chronic limb-threatening ischemia (CLTI) who underwent endovascular revascularization followed by TMA. Patients were categorized into early TMA (≤7 days after revascularization) and late TMA (8-30 days). Propensity score matching was performed using demographics, comorbidities, laboratory values, and concurrent therapies. Major amputation and all-cause mortality at 6 months and 1 year were evaluated using Cox proportional hazards models. Kaplan–Meier curves and log-rank tests were used for time-to-event analyses.\n\nResults: Among 700 patients with CLTI treated with revascularization before TMA, 508 underwent early TMA and 192 underwent late TMA. After matching, 185 patients remained in each group (96.3% match rate). The mean age was 66.9 ± 10.9 years, 78.1% were male, and mean follow-up was 237.2 days. At 6 months, major amputation (hazard ratio [HR], 0.87; 95% CI, 0.51-1.46; P =.597) and all-cause mortality (HR, 0.74; 95% CI, 0.45-1.20; P = .220) did not differ between groups. At 1-year, major amputation (HR, 0.87; 95% CI, 0.52-1.45; P = .599) and mortality (HR, 0.73; 95% CI, 0.46-1.14; P = .164) also remained similar. A composite endpoint of major amputation or all-cause mortality was also similar between groups (HR, 0.995; 95% CI, 0.694-1.425; P = .978).\n\nConclusion: Among patients with CLTI undergoing endovascular therapy and subsequent TMA, early (≤7 days) vs late (8-30 days) amputation timing did not significantly affect major amputation or survival outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, Cleveland, Ohio",
    "Hawken School, Cleveland, Ohio",
    "Department of Medicine, University Hospitals, Cleveland, Ohio"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ashkan Yahyavi"
    },
    {
      "affs": [
        0
      ],
      "name": "Leen Hussein"
    },
    {
      "affs": [
        1
      ],
      "name": "Zakarias H. Shishehbor"
    },
    {
      "affs": [
        0
      ],
      "name": "Yara Shatnawi"
    },
    {
      "affs": [
        2
      ],
      "name": "Maedeh Zokaei Nikoo"
    },
    {
      "affs": [
        0
      ],
      "name": "Mehdi H. Shishehbor"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/egvt5cddpr4dc.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jscai.2026.105623",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13700053/",
  "id": "egvt5cddpr4dc",
  "issns": [
    "2772-9303"
  ],
  "landing_url": "https://doi.org/10.1016/j.jscai.2026.105623",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2746|Peripheral Artery Disease Management"
    ]
  ],
  "openalex": "W7204449949",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13700053/pdf/?tool=EBI",
  "pmcid": "PMC13700053",
  "pmid": "42936599",
  "published": "2026-08-27",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/egvt5cddpr4dc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:34Z",
      "native_id": "PMC13700053",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jscai.2026.105623"
    },
    {
      "first_seen": "2026-10-30T12:21:51Z",
      "native_id": "PMC:PMC13700053",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13700053"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Peripheral Artery Disease Management",
      "subfield": "surgery"
    }
  ],
  "title": "Early Versus Delayed Endovascular Revascularization: Implications for Limb Salvage and Survival After Transmetatarsal Amputation",
  "title_text": "Early Versus Delayed Endovascular Revascularization: Implications for Limb Salvage and Survival After Transmetatarsal Amputation",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:36:32Z",
  "url": "https://research.draconitic.com/paper/egvt5cddpr4dc",
  "venue": "Journal of the Society for Cardiovascular Angiography & Interventions",
  "versions": []
}