{
  "abstract": "Background: Chronic limb-threatening ischemia (CLTI) carries a high risk of amputation and mortality. We evaluated short-term clinical, hemodynamic, and quality-of-life outcomes after open lower-extremity surgical revascularization in a Yemeni cohort.\n\nMethods: This single-center prospective observational cohort study was conducted at Al-Thawra Modern General Hospital, Sana'a, Yemen. We enrolled 39 consecutive adults with CLTI (Rutherford categories 4-6) who were selected for and considered fit to undergo open lower-extremity surgical revascularization between December 2022 and September 2024; follow-up was completed in December 2024. The study protocol was reviewed and approved by the Al-Thawra Hospital Ethics Committee (approval no. 33-2026), and written informed consent was obtained from all participants. The study was not registered. This was an exploratory consecutive cohort; no formal sample-size calculation was performed, and no contemporaneous endovascular, nonoperative, or primary-amputation comparator group was included. Primary endpoints were graft patency and limb salvage at three months. Secondary outcomes were secondary patency, postoperative complications, and changes in ankle-brachial index (ABI) and Vascular Quality of Life Questionnaire-6 (VascuQoL-6) scores. Paired comparisons used Wilcoxon signed-rank tests; Fisher's exact tests were used for categorical comparisons.\n\nResults: The mean age was 60.9 years (SD 9.7), and 30 patients (76.9%) were male. Diabetes mellitus and hypertension were present in 34 (87.2%) and 30 (76.9%) patients, respectively. Nineteen patients (48.7%) had ischemic rest pain, and 20 (51.3%) had tissue loss. Great saphenous vein (GSV) and polytetrafluoroethylene (PTFE) grafts were used in 28 (71.8%) and 11 (28.2%) patients, respectively. At three months, primary patency was 84.6% (33/39 grafts; 95% CI 70.3%-92.8%), secondary patency was 89.7% (35/39 grafts; 95% CI 76.4%-95.9%), and limb salvage was 89.7% (35/39 patients; 95% CI 76.4%-95.9%). Given the small cohort, the confidence intervals around these estimates were relatively wide. Among the 35 patients with limb preservation, mean ABI increased from 0.35 (SD 0.11) to 0.55 (SD 0.12; mean difference 0.21, 95% CI 0.19-0.23; p<0.001), and mean VascuQoL-6 score increased from 10.3 (SD 2.9) to 16.6 (SD 4.0; mean difference 6.3, 95% CI 5.6-7.1; p<0.001). Complications occurred in nine patients (23.1%). In an exploratory unadjusted subgroup analysis, GSV use was associated with higher primary patency than PTFE use (92.9% vs 63.6%, p=0.042).\n\nConclusion: In this single-center prospective cohort, open surgical revascularization was feasible and was associated with 89.7% limb salvage and 84.6% primary patency at three months. Improvements in ABI and VascuQoL-6 were observed among patients with limb preservation. Autologous GSV use was associated with higher primary patency; this finding requires confirmation in larger, adjusted studies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Vascular Surgery, Faculty of Medicine and Health Sciences, Sana’a University, Sana'a, YEM",
    "Department of Cardiac Surgery, Al-Thawra Modern General Hospital, Sana’a, YEM",
    "Department of Vascular Surgery, Al-Thawra Modern General Hospital, Sana'a, YEM"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nabeel Y Al-Modwahi"
    },
    {
      "affs": [
        1
      ],
      "name": "Ali M Fadhel"
    },
    {
      "affs": [
        2
      ],
      "name": "Al-Ezy M Hamoud"
    },
    {
      "affs": [
        2
      ],
      "name": "Yahya A Al-Modwahi"
    },
    {
      "affs": [
        2
      ],
      "name": "Emad A Halboob"
    },
    {
      "affs": [
        2
      ],
      "name": "Aref Al-Hashedi"
    },
    {
      "affs": [
        2
      ],
      "name": "Mohammed A Al-Mnari"
    },
    {
      "affs": [
        2
      ],
      "name": "Milad A Al-Motawakill"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fve146qbnvk14.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117253",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722522/?tool=EBI",
  "id": "fve146qbnvk14",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13722522",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Cardiac/Thoracic/Vascular Surgery"
    ],
    [
      "heading",
      "General Surgery"
    ],
    [
      "openalex",
      "2746|Peripheral Artery Disease Management"
    ]
  ],
  "openalex": "W7214890744",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722522/pdf/?tool=EBI",
  "pmcid": "PMC13722522",
  "pmid": "42964954",
  "published": "2026-09-30",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/fve146qbnvk14.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:36Z",
      "native_id": "PMC:PMC13722522",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13722522"
    },
    {
      "first_seen": "2026-11-03T12:23:00Z",
      "native_id": "PMC13722522",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117253"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Peripheral Artery Disease Management",
      "subfield": "surgery"
    }
  ],
  "title": "Short-Term Outcomes of Lower-Extremity Surgical Revascularization for Chronic Limb-Threatening Ischemia Among Yemeni Patients: A Prospective Observational Study",
  "title_text": "Short-Term Outcomes of Lower-Extremity Surgical Revascularization for Chronic Limb-Threatening Ischemia Among Yemeni Patients: A Prospective Observational Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:23:00Z",
  "url": "https://research.draconitic.com/paper/fve146qbnvk14",
  "venue": "Cureus",
  "versions": []
}