Journal of NeuroInterventional Surgery最新文献

{"title":"Pipeline shield reduces diffusion-weighted imaging-detected ischemia after intracranial aneurysm treatment compared with pipeline flex: a propensity score-matched retrospective cohort study.","authors":"Ryo Akiyama, Akira Ishii, Hideo Chihara, Chiaki Sakai, Takayuki Kikuchi, Masakazu Okawa, Taichi Ikedo, Shigeki Takada, So Matsukawa, Yoshiki Arakawa","doi":"10.1136/jnis-2025-023229","DOIUrl":"https://doi.org/10.1136/jnis-2025-023229","url":null,"abstract":"<p><strong>Background: </strong>The Pipeline Flex embolization device with Shield technology (PED Shield, Medtronic, Irvine, CA, USA) is a flow diverter designed to reduce thrombogenicity through phosphorylcholine surface modification. Although in vitro and in vivo studies have demonstrated the thrombogenicity reducing effects of this technology, its effectiveness in real-world clinical practice remains unclear. This study aims to compare the number of post-procedure diffusion-weighted imaging (DWI)-positive lesions between PED Flex(Medtronic, Irvine, CA, USA) and PED Shield to assess the impact of surface modification.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with unruptured intracranial aneurysms treated with PED Flex or PED Shield between April 2016 and March 2024 at a single institution. Propensity score matching was performed to control for confounders, and the number of post-procedure DWI-positive lesions was evaluated as the primary outcome.</p><p><strong>Results: </strong>In total, 148 procedures (132 patients, 138 aneurysms) were included, with 68 (46%) treated with PED Flex and 80 (54%) with PED Shield. Propensity score matching resulted in 47 matched pairs. After matching, the median number of post-procedure DWI-positive lesions was nine (interquartile range (IQR): 3-17) in the PED Flex group and three (IQR: 1-6) in the PED Shield group, with a significantly lower number in the PED Shield group (regression coefficient β = -10.70 [95% confidence interval (CI): -16.23 to -5.16), P<0.001).</p><p><strong>Conclusion: </strong>After adjusting for confounders, the PED Shield group had significantly fewer post-procedure DWI-positive lesions than the PED Flex group, suggesting that phosphorylcholine surface modification technology may reduce thrombogenicity in real-world clinical practice.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hydrogel vascular closure device for hemostasis after transfemoral intervention: a randomized controlled clinical trial.","authors":"Shuhong Yu, Zhichao Huang, Zhimai Lyu, Min Li, Bo Ye, Guoyong Zeng, Jiaping Xu, Huaishun Wang, Jie Hou, Yuehui Liu, Yage Zhao, Zhiliang Guo, Guodong Xiao","doi":"10.1136/jnis-2025-023386","DOIUrl":"https://doi.org/10.1136/jnis-2025-023386","url":null,"abstract":"<p><strong>Background: </strong>In this randomized controlled trial we aim to validate the efficacy and safety of a hydrogel vascular closure device (VCD) for hemostasis after transfemoral intervention.</p><p><strong>Methods: </strong>Between January and August 2023, 212 patients were enrolled, including 202 in a non-inferiority randomized controlled trial (1:1 hydrogel vs ExoSeal; prespecified margin -10%) and 10 in a hydrogel-only observational arm (8 F). The primary endpoint was device success rate and secondary endpoints including hemostasis time and procedural blood loss.</p><p><strong>Results: </strong>Among 102 hydrogel and 100 ExoSeal recipients, hydrogel had non-inferior success rates (99.02% vs 94.00%; 95% CI -0.27% to 11.74%). Hydrogel achieved significantly faster hemostasis (1.99 vs 3.14 min, P<0.001) and reduced blood loss (0.83 mL vs 8.93 mL, P<0.001). No major access site complications were observed in either group. No secondary complications occurred in patients in the experimental group and secondary complications occurred in one patient in the control group (P=0.497). The supplementary cohort of 10 patients supported the efficacy and safety of hydrogel VCD.</p><p><strong>Conclusions: </strong>Hydrogel VCD shows non-inferior efficacy to ExoSeal for transfemoral cerebrovascular interventions, with superior hemostatic speed and reduced blood loss while maintaining comparable safety.</p><p><strong>Trial registration number: </strong>ChiCTR2300068029 (https://www.chictr.org.cn/showproj.html?proj=178962).</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of single plane and biplane angiography systems for mechanical thrombectomy for acute ischemic stroke: a systematic review and meta-analysis.","authors":"Atakan Orscelik, Cem Bilgin, Jonathan Cortese, Joshua J Cayme, Sara Zandpazandi, Yigit Can Senol, Basel Musmar, Sherief Ghozy, Esref Alperen Bayraktar, Zahra Beizavi, Waleed Brinjikji, David F Kallmes","doi":"10.1136/jnis-2024-022381","DOIUrl":"10.1136/jnis-2024-022381","url":null,"abstract":"<p><strong>Background: </strong>The choice of angiography system could influence the outcomes of mechanical thrombectomy (MT) in the treatment of acute ischemic stroke (AIS), but its impact is not yet well understood. This study aims to compare the clinical and technical outcomes of MT performed with single plane versus biplane angiography systems.</p><p><strong>Method: </strong>We conducted a systematic review and meta-analysis, following PRISMA guidelines, by searching PubMed, Embase, Web of Science, and Scopus to include studies on patients with AIS who underwent MT with either single plane or biplane angiography up to May 4, 2024. The primary outcome was a favorable outcome defined as a modified Rankin Scale (mRS) score of 0-2 at 90 days after the procedure. Data were analyzed using a random-effects model and heterogeneity was assessed using the I² test and Q statistics.</p><p><strong>Results: </strong>Five studies with a total of 1562 patients were analyzed. Of these, 68.4% were treated with biplane systems and 31.6% with single plane systems. Single plane angiography was associated with a significantly higher rate of favorable outcomes (OR 1.43; 95% CI 1.13 to 1.80; P<0.01). There were no significant differences in successful recanalization, periprocedural complications, procedure time, total fluoroscopy time, or contrast volume between the two systems.</p><p><strong>Conclusion: </strong>While single plane angiography systems may offer slightly better outcomes in MT for AIS, both systems appear equally effective in most clinical and technical perspectives, suggesting that system selection may be more dependent on availability and procedural requirements rather than inherent superiority. Our findings may encourage clinicians to use single-plane angiography in settings where the biplane angiography suite availability is limited, but it should be noted that this observation may have been influenced by selection bias, particularly since the larger studies included in our meta-analysis did not observe this effect in adjusted analyses for potential confounder factors.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"567-573"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on 'Intraoperative cerebral angiography reveals microsurgically occult sequelae of temporary clip application during elective cerebral aneurysm surgery' by Hendrix <i>et al</i>.","authors":"Xuefan Zeng, Yiwei Wang, Yi Yang","doi":"10.1136/jnis-2024-022762","DOIUrl":"10.1136/jnis-2024-022762","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e10"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular coil embolization through a previously implanted Contour intrasaccular device for recurrent posterior communicating artery aneurysm.","authors":"Daniele Piccolo, Krizia Maria Cannizzo, Marco Vindigni, Massimo Sponza, Vladimir Gavrilovic","doi":"10.1136/jnis-2025-023473","DOIUrl":"https://doi.org/10.1136/jnis-2025-023473","url":null,"abstract":"<p><p>Intrasaccular flow diverters such as the Contour Neurovascular System represent a significant advancement in the endovascular management of intracranial aneurysms, particularly those with complex bifurcation morphology. However, complications such as incomplete occlusion or recurrence post-implantation remain prevalent challenges in clinical practice. Depending on the specific failure mode and anatomy, various bailout strategies may involve parent vessel reconstruction with flow diverters or surgical clipping.1-4This technical video (video 1) shows a novel bailout strategy that integrates adjunctive coil embolization through a pre-existing Contour device to address aneurysm recurrence. Key procedural elements are demonstrated, including microcatheter navigation into the residual aneurysm sac adjacent to the Contour, precise coil deployment into the interstice between the device and the aneurysm wall, and achieving complete angiographic occlusion while preventing any displacement or compromise of functionality of the existing intrasaccular device. This technique exemplifies a viable endovascular rescue approach for selected instances of aneurysm recurrence following Contour treatment, enhancing the therapeutic armamentarium available to clinicians.neurintsurg;jnis-2025-023473v1/V1F1V1Video 1 Endovascular coil embolization through a previously implanted Contour intrasaccular device for recurrent posterior communicating artery aneurysm.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on 'Impact of duration of dual anti-platelet therapy on risk of complications after stent-assisted coiling of unruptured aneurysms' by Ringer <i>et al</i>.","authors":"Xuefan Zeng, Yiwei Wang, JingJing Li, Yifei Gong, Guojun Cheng","doi":"10.1136/jnis-2024-022778","DOIUrl":"10.1136/jnis-2024-022778","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e4"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is invasive fractional flow measurement accurate in intracranial stenosis? A computational simulation study.","authors":"Yu Liu, Zhengzheng Yan, Ziqi Li, Yuying Liu, Sze Ho Ma, Bonaventure Yiu Ming Ip, Thomas Wai Hong Leung, Jia Liu, Xinyi Leng","doi":"10.1136/jnis-2025-023342","DOIUrl":"https://doi.org/10.1136/jnis-2025-023342","url":null,"abstract":"<p><strong>Background: </strong>In intracranial atherosclerotic stenosis (ICAS), low fractional flow (FF) may indicate hemodynamic significance.</p><p><strong>Objective: </strong>To investigate, using simulation models, whether invasive measurement could accurately reflect 'true' FF, when the catheter/pressure wire might disturb focal flow during measurement.</p><p><strong>Methods: </strong>We recruited 5 patients with high-grade, symptomatic M1 middle cerebral artery stenosis in three-dimensional rotational angiography (3DRA). In each case, the stenotic severity was manually manipulated to 50%, 60%, 70%, and 80%. At each stenotic severity, we simulated four situations: no catheter/pressure wire insertion ('in vivo' status); only catheter inserted proximally to the ICAS; catheter inserted and pressure sensor placed at 1 cm and 2 cm distally to the ICAS lesion. The blood flow was simulated with computational fluid dynamics modeling, and FF measured as post-stenotic and pre-stenotic pressure ratio. We calculated relative differences of FFs simulated at other situations compared with in vivo status.</p><p><strong>Results: </strong>Compared with in vivo status, catheter insertion had no significant influence on simulated FFs. With pressure wire passing through the ICAS, simulated FFs slightly decreased (mostly <10%) at 50% and 60% stenoses, which significantly decreased (up to 50% and 88%) at 70% and 80% stenoses. The effects of pressure wire on FFs were similar when the pressure sensor was placed at 1 cm and 2 cm distally to the ICAS.</p><p><strong>Conclusions: </strong>Invasive measurement of FF may overestimate the hemodynamic significance of ICAS with severe stenosis, as the pressure wire may further reduce the flow across the small residual lumen. The findings warrant verification in larger-scale studies, with information on collateral circulation and validation with other imaging modalities.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First clinical multicenter experience of the new NeVa NET 5.5 thrombectomy device.","authors":"Roland Schwab, Balázs Kis, Berki Alexandra Réka, Janos Sebestyen Gellen, Katharina Haider, Eya Khadhraoui, Sebastian Johannes Müller, Erelle Fuchs, Maximilian Thormann, Johannes Alex Rolf Pfaff, Daniel Behme","doi":"10.1136/jnis-2025-023476","DOIUrl":"https://doi.org/10.1136/jnis-2025-023476","url":null,"abstract":"<p><strong>Background: </strong>Mechanical thrombectomy for the treatment of acute ischemic stroke has undergone relevant technical improvements over recent years. However, distal emboli and incomplete reperfusion after mechanical thrombectomy are still shortcomings in the care of patients with endovascular acute ischemic stroke. The NeVa NET 5.5 thrombectomy device (Vesalio, Nashville, Tennessee, USA) is the first stent retriever featuring an integrated clot micro-filtration system, aiming to enhance first pass efficacy and reduce distal embolization. This study evaluates the safety and efficacy of the NeVa NET 5.5 thrombectomy device.</p><p><strong>Methods: </strong>Patients with acute anterior circulation occlusions and vessel diameters >2 mm treated with the NeVa NET 5.5 stent retriever as a first-line approach were retrospectively included in this study. Data were collected from three European comprehensive stroke centers between October 2022 and April 2024. Patient data, occlusion details, clinical outcomes, and procedure-related parameters were analyzed.</p><p><strong>Results: </strong>A total of 51 patients were included. The most common occlusion locations were the internal carotid artery terminus and intradural internal carotid artery (70.6%). The mean±SD clot length was 25.1±13.3 mm (range 4-50 mm). First pass reperfusion (eTICI 2b-3) was achieved in 78.5%, with a final reperfusion rate of eTICI 2b-3 in 98.1%. Distal embolization in new territories occurred in 3.9%. No device-related adverse events were reported, and procedure-related adverse events occurred in 7.6% of the overall included cases.</p><p><strong>Conclusion: </strong>The NeVa NET 5.5 stent retriever has a high first pass reperfusion rate in large vessel occlusions of the anterior circulation, with a good safety profile and low rate of distal embolization.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 'Slingshot' technique: balloon-guide assisted tracking of distal systems past tortuosity and ledges in thrombectomy.","authors":"Albert Q Wu, Kyle Scott, Redi Rahmani, Sandeep Kandregula, Bryan Pukenas, Joshua S Catapano, Visish M Srinivasan, Jan Karl Burkhardt","doi":"10.1136/jnis-2025-023089","DOIUrl":"https://doi.org/10.1136/jnis-2025-023089","url":null,"abstract":"<p><strong>Background: </strong>We describe and analyze a novel technique by which inflation of a proximal balloon guide catheter (BGC) permits tracking of distal catheter systems past vessel tortuosity and ledges like the ophthalmic segment of the internal carotid artery (ICA). Inflation of the BGC counteracts slippage when deployed, and careful advancement of the system builds up energy that is translated forward, allowing users to cross segments otherwise inaccessible by endovascular techniques.</p><p><strong>Methods: </strong>A retrospective review of our institutional neurovascular database was conducted, and we identified nine patients for whom the novel 'Slingshot' technique was used for mechanical thrombectomy. Patient characteristics, outcomes, and procedural steps were collected and analyzed with regards to safety and efficacy of the technique.</p><p><strong>Results: </strong>The Slingshot technique was successful in all nine cases to navigate the distal system to the target location. For all cases, conventional tracking of the catheter failed, and the Slingshot technique was used as a rescue. No intraoperative complications such as vessel dissection or perforation were observed. First pass recanalization was achieved in seven (78%) cases with successful reperfusion (thrombolysis in cerebral infarction ((TICI) ≥2B) in all cases. Patient outcome was favorable with National Institutes of Health Stroke Scale (NIHSS) score improvement from a median of 16 to 3 postoperatively.</p><p><strong>Discussion: </strong>For neurovascular procedures in which advancement of an intermediate catheter or other equipment is limited by ledges or tortuosity, the Slingshot technique is a safe and effective way to reach the intended target position and does not require additional catheters or devices.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aiming for TICI 4: angiographic and ultrasonographic predictors of parenchymal hemorrhage after successful thrombectomy.","authors":"João André Sousa, Carolina Maia, Catarina Bernardes, Henrique Queirós, Ana Isabel Rodrigues, Adriana Henriques, Ana Inês Martins, Ana Brás, Luciano Almendra, Carla Cecília Nunes, Cristina Machado, Bruno Rodrigues, César Nunes, Gustavo Santo, Fernando Silva, Ricardo Veiga, Egídio Machado, João Sargento-Freitas","doi":"10.1136/jnis-2025-023273","DOIUrl":"https://doi.org/10.1136/jnis-2025-023273","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhagic transformation after thrombectomy is associated with poor outcomes. This study aimed to assess post-thrombectomy angiographic signs and increased blood flow on transcranial Doppler as potential predictive factors for parenchymal hemorrhage after successful endovascular stroke treatment.</p><p><strong>Methods: </strong>This cohort study included consecutive patients who underwent endovascular stroke treatment at a comprehensive stroke center with successful recanalization and 24-hour follow-up imaging available. Angiographic post-thrombectomy signs, including the blush sign, early venous filling, and punctate dilations, were retrospectively and blindly assessed. The mean blood flow velocity ratio of the recanalized artery was collected and compared with the contralateral artery, defining hyperperfusion as a ratio greater than 1.3. Control 24-hour CT scans were reviewed, and hemorrhagic transformation was classified. Unadjusted and clinical variable-adjusted logistic regression analyses were performed.</p><p><strong>Results: </strong>A total of 362 patients were included in the analysis, with 28 (7.7%) presenting with parenchymal hemorrhage. The blush sign (adjusted OR 3.6, 95% CI 1.3 to 9.4, P=0.01), early venous filling (adjusted OR 6.1, 95% CI 1.9 to 20.0, P=0.003), a combination of both signs (adjusted OR 7.9, 95% CI 2.0 to 30.8, P=0.003), and Doppler-assessed hyperperfusion (adjusted OR 5.9, 95% CI 1.1 to 31.5, P=0.038) were independent predictors of parenchymal hemorrhage. A model incorporating these three variables presented an area under the curve of 0.82 (95% CI 0.67 to 0.99, P<0.001), indicating excellent predictive accuracy for identifying parenchymal hemorrhage following successful thrombectomy.</p><p><strong>Conclusion: </strong>Angiography and transcranial Doppler ultrasonography may provide early signs that accurately predict parenchymal hemorrhage following successful recanalization.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}