Annals of vascular surgery. Brief reports and innovations最新文献

{"title":"Electrocautery wire fenestration prior to thoracic endovascular aortic repair to optimize the distal landing zone in thoracic aortic dissections","authors":"Nicola Habash ,&nbsp;Gaurang Joshi ,&nbsp;Mohammed Ali ,&nbsp;Michael Nooromid ,&nbsp;Babak Abai","doi":"10.1016/j.avsurg.2024.100317","DOIUrl":"10.1016/j.avsurg.2024.100317","url":null,"abstract":"<div><p>Successful thoracic endovascular aortic repair (TEVAR) for type B aortic dissections (TBAD) relies on securing the stentgraft's distal landing zone to prevent retrograde flow and false lumen pressurization. We describe a 60-year-old male with a TBAD undergoing TEVAR with electrocautery-wire fenestration of the dissection septum, providing a controlled method to enhance the distal landing zone for graft placement. Postoperatively, the patient experienced spinal cord ischemia, resolving with the placement of a lumbar drain and increasing mean arterial pressures. Follow-up imaging demonstrated a well-sealed repair without endoleaks. This case highlights the importance of surgical technique selection and postoperative monitoring for complications.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100317"},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000692/pdfft?md5=167143809e22cba3622dc7acb23ec7d5&pid=1-s2.0-S2772687824000692-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic outlet syndrome in dialysis patients: A case series and review","authors":"Dorcie Ann Gillette ,&nbsp;Albert Pedroza ,&nbsp;Maen Aboul Hosn","doi":"10.1016/j.avsurg.2024.100315","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100315","url":null,"abstract":"<div><p>Thoracic outlet syndrome (TOS) is a rare condition that results from compression of the neurovascular structures as they pass through the thoracic outlet. In this case series, we report on three patients who developed TOS following the creation of an upper extremity arteriovenous fistula (AVF). Patients were successfully treated with first rib resection and pec minor release with venoplasty and neurolysis as indicated. Surgical intervention improved symptoms and preserved dialysis access function in all patients. Thus, with the right constellation of symptoms, clinicians should consider TOS as a differential in patients following AVF creation.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100315"},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000679/pdfft?md5=fc5cf41b7008cad3965f974d61d436c3&pid=1-s2.0-S2772687824000679-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood letting as an ancient cure for an unusual manifestation of polycythemia","authors":"Margarita I Pipinos ,&nbsp;Elizabeth A Amato-Hanner ,&nbsp;Aaron M Murray ,&nbsp;Shalmali Mirajkar ,&nbsp;Jennifer L Gamache ,&nbsp;Safina Hafeez ,&nbsp;Tanya M Wildes ,&nbsp;Jason N MacTaggart","doi":"10.1016/j.avsurg.2024.100311","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100311","url":null,"abstract":"<div><p>A 52-year-old woman presented with acute digital ischemia and pain in all five digits of her right hand. Upper extremity arterial duplex demonstrated normal flow to the wrist, but upper extremity Computed Tomography Angiography (CTA) demonstrated an atretic appearing brachial artery at the mid-humerus, variant superficial ulnar artery, and a radial artery that truncated at the wrist. The patient was diagnosed with digital ischemia secondary to polycythemia and was started on intravenous anticoagulation. Her symptoms improved and she was converted to oral anti-coagulation and anti-platelet therapy supplemented by weekly therapeutic phlebotomy. The patient's condition improved at 1-month follow up, as indicated by laboratory, imaging, and symptoms. In this case report, we detail the presentation and management of upper extremity ischemia in the setting of polycythemia in a patient with small, tortuous, and aberrant vasculature.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100311"},"PeriodicalIF":0.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000631/pdfft?md5=a4a802006fe5ae917749ee8bc2092f18&pid=1-s2.0-S2772687824000631-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141593814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage of a kidney transplant with a mycotic extrarenal pseudoaneursym using donor vessels","authors":"Audrey Horn ,&nbsp;Kelli L. Summers ,&nbsp;William Fuell ,&nbsp;Adarsh Vijay ,&nbsp;Hoonbae Jeon ,&nbsp;Melissa Donovan ,&nbsp;Kiara Tulla ,&nbsp;Anil Paramesh","doi":"10.1016/j.avsurg.2024.100314","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100314","url":null,"abstract":"<div><p>A 63-year-old male developed a mycotic pseudoaneurysm (MPA) two months after a renal transplant at the anastomotic site. He presented with uncontrolled hypertension and elevated creatinine. The pseudoaneurysm occurred at the anastomosis between the two donor renal arteries and the left external iliac artery. We describe a unique surgical reconstruction where the MPA was resected and the vasculature was reconstructed using deceased donor vessels. A deceased donor common iliac artery including superior gluteal and inferior gluteal branches were used as a jump graft from the contralateral common iliac artery to the two transplanted renal arteries. The external iliac artery was repaired with an interposition bypass using deceased donor iliac vein. The patient received 8 weeks of antifungal therapy after the specimen grew candida albicans. Post-operatively, the patient had an acute kidney injury requiring dialysis, but after two months of dialysis, his renal function returned to normal and he remains dialysis-free.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100314"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000667/pdfft?md5=e44344ce88ee20dfe204028dcc376f19&pid=1-s2.0-S2772687824000667-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External iliac artery endofibrosis in females: Case reports and review of the literature","authors":"Christine A. Parks ,&nbsp;Winsor P. Chen ,&nbsp;Christopher G. Gomez ,&nbsp;Nicos Labropoulos ,&nbsp;George Koullias ,&nbsp;Scott S. Berman ,&nbsp;Luis R. Leon Jr.","doi":"10.1016/j.avsurg.2024.100313","DOIUrl":"10.1016/j.avsurg.2024.100313","url":null,"abstract":"<div><p>In the past four decades, reports of an unusual vascular disease affecting young and otherwise healthy endurance athletes have begun to emerge. This rare entity has been coined as external iliac artery endofibrosis (EIAE). It has been primarily described in high-level competitive cyclists, suggesting a biomechanical etiology given the repetitive flexion and extension of the hip joint associated with cycling.^1,2 Patients present with symptoms of claudication at peak levels of exertion, levels not usually achievable by the untrained individual. Lesions are predominantly isolated to the external iliac artery (EIA), and histologic examination reveals endothelial thickening and fibrosis without evidence of atherosclerosis.^1–5 Cases of EIAE have been overwhelmingly described in male athletes, with a paucity of reports in females.^2,3 We herein describe two cases of elite female athletes afflicted by EIAE and review the current literature pertaining to this entity in females. Both patients consented to publication of their case details and images.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000655/pdfft?md5=3e9e59f5b8901dc50b1937fcfcda093f&pid=1-s2.0-S2772687824000655-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptured infectious pseudoaneurysm of the common carotid artery in a 14-year-old girl. management in the DR Congo","authors":"Alphonse NZOMVUAMA ,&nbsp;Jean-Jacques KALONGO ,&nbsp;Blondel BAYENEKENE ,&nbsp;Stéphane YANDA ,&nbsp;M. Jacques NSUAMI","doi":"10.1016/j.avsurg.2024.100312","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100312","url":null,"abstract":"<div><p>The infectious pseudoaneurysm of the common carotid artery is a rare observation in children. We present a case of ruptured infectious common carotid aneurysm in a 14-year-old girl managed in the Democratic Republic of Congo. We performed an arterial reconstruction with a saphenous vein patch. Post-operative course was simple. The patient was discharged from the hospital at post-operative day 15. She was doing well and had returned to school. Rupture of an infectious pseudoaneurysm of the common carotid artery constitutes a serious, life-threatening accident. As we have shown in this case report, its management with successful results is indeed possible, even in a resource-limited environment.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100312"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000643/pdfft?md5=1fb0098332760d3108e220b97201681c&pid=1-s2.0-S2772687824000643-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic limb threatening ischemia due to radiation-induced arteriopathy 30 years after soft tissue sarcoma resection and radiation therapy: Case report and review of the literature","authors":"Camilo Polania Sandoval,&nbsp;Houssam Farres,&nbsp;Yaman Alsabbagh,&nbsp;Young Erben","doi":"10.1016/j.avsurg.2024.100310","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100310","url":null,"abstract":"<div><h3>Introduction</h3><p>Peripheral artery disease (PAD) affects over 200 million people globally. A small subset of PAD patients are a result of radiation-induced peripheral artery disease (RIPAD). Radiation changes affect vascular physiology and cause arteriopathy with vessel damage and subsequent occlusion. This report details a case of common femoral and superficial femoral artery RIPAD with a review of the existing literature.</p></div><div><h3>Case report</h3><p>A 40-year-old male patient presented with a six-month history of left leg rest pain. He had 30 years prior synovial cell sarcoma of the thigh treated with chemo- and radiation therapy with chronic residual lymphedema managed with compression therapy. Preoperative non-invasive studies demonstrated an ankle-brachial index of 0.42. Computed tomography angiography of the leg demonstrated a small caliber external iliac artery and occlusion of the common femoral and superficial femoral arteries. A left external iliac to above-the-knee popliteal artery bypass using a contralateral great saphenous vein was performed. Six weeks after operative intervention, the groin wound broke down and became infected. He required emergent repair of this bypass using 4 cm cryopreserved vein interposition graft. Intraoperative cultures were positive for Staphylococcus epidermidis and Finegoldia magna. At a 4.5-year follow-up, the patient remains active with a patent bypass and continues to manage his leg lymphedema with thigh-high elastic compression stockings.</p></div><div><h3>Conclusion</h3><p>Clinical expertise is required to detect RIPAD early on. There is a high risk for post-operative complications due to radiation damage to surrounding tissues. Open surgical repair is the preferred treatment strategy. Lymphedema and wound healing complications are key to managing patients affected by RIPAD.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100310"},"PeriodicalIF":0.0,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277268782400062X/pdfft?md5=3122f4650bd7a99d89387a75536c07a3&pid=1-s2.0-S277268782400062X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extra-anatomic bypasses as perfusion alternatives in the treatment of complex thoracoabdominal aortic disease","authors":"Jorge Rey ,&nbsp;Christopher Montoya ,&nbsp;Camilo A. Polania-Sandoval ,&nbsp;Christopher Chow ,&nbsp;Stefan Kenel-Pierre ,&nbsp;Matthew Sussman ,&nbsp;Arash Bornak","doi":"10.1016/j.avsurg.2024.100309","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100309","url":null,"abstract":"<div><h3>Introduction</h3><p>The management of thoracoabdominal aortic aneurysms (TAAA) presents significant challenges for vascular and cardiothoracic surgeons due to the risk of ischemic complications. Various strategies have been implemented over time, including open repair with or without left heart bypass (LHB), endovascular, and hybrid approaches. Here, we explore the application of temporary extra-anatomic bypasses (TEAB) as a technique for complex open TAAA repair when the traditional standard of care is not feasible (i.e. Unavailability of LHB) or indicated (i.e. contraindication for systemic heparinization for LHB).</p></div><div><h3>Case reports</h3><p>Case 1 is an undomiciled 59-year-old male with a chronic type B dissection (CTBD) and degenerative TAAA with failed attempt at endovascular repair at an outside institution. An open repair of the visceral segment was performed with TEAB due to risk of impending rupture, prior failed endovascular repair, and unavailability of cardiac surgery. Additionally, a staged TEVAR was planned for treatment of the thoracic portion of the CTBD in two weeks’ time. The patient experienced sudden chest pain 10 days following the TAAA repair, prompting urgent TEVAR. No complications were observed. Case 2 is a 65-year-old male with a type 2 TAAA who underwent an open repair with the use of TEAB. Technical success was achieved with no complications.</p></div><div><h3>Discussion</h3><p>TAAA repair poses significant challenges <strong>regardless of</strong> the approach selected. However, the use of TEAB has shown promise in ensuring adequate perfusion of vital organs during complex repair when LHB is not an option. Preoperative planning is essential to minimize ischemic time and reduce complications. Studies have shown favorable outcomes with TEAB, however, evidence relies only on small series and case reports.</p></div><div><h3>Conclusion</h3><p>The use of TEAB is a valuable technique for safeguarding organ perfusion during open repair of TAAA. While further research and experience are needed, TEAB offers a promising alternative for cases where traditional approaches are not available. Continued exploration and documentation of TEAB in current literature will contribute to optimizing TAAA management strategies.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100309"},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000618/pdfft?md5=b214a4a34317cc49d92433c0855ebd2b&pid=1-s2.0-S2772687824000618-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141487300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach in the management of splenomesenteric artery aneurysms, case report and review of the literature","authors":"Abdullah J. AlShehri ,&nbsp;Abdulaziz A. Banaja ,&nbsp;Patrick Feugier","doi":"10.1016/j.avsurg.2024.100308","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100308","url":null,"abstract":"<div><h3>Introduction</h3><p>Aneurysms of the splenomesenteric artery variant are extremely rare with an unusual location; making its management approach challenging.</p></div><div><h3>Case presentation</h3><p>We report a case of splenomesenteric artery aneurysms that was managed in an endovascular approach in a 56-year-old gentleman with co-morbidity, obesity and anticoagulation treatment. A computed tomography investigating a left flank pain found a left sub-capsular renal hematoma and an incidental finding of a fusiform splenic artery aneurysm originating from the SMA measuring 3.2 × 3.4 cm. An endovascular intervention was performed by combining an embolization of the aneurysm and emplacement of stent graft at the superior mesenteric artery to isolate the aneurysm and prevent coil migration. The patient was discharged at day 2 post-operatively with excellent clinical and radiographic findings upon follow-ups.</p></div><div><h3>Discussion</h3><p>Splenomesenteric artery aneurysms is rare as there are 47 published cases reported in the literature. They may present with abdominal pain, back pain, flank pain or discovered incidentally. Its open surgical management approach pose various potential difficulties due to its retropancreatic location. Other approaches were proposed in the literature including laparoscopic and endovascular managements.</p></div><div><h3>Conclusion</h3><p>An appropriate endovascular management can be more feasible and suitable approach management of splenomesenteric artery aneurysms in patients with complicated medical condition.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100308"},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000606/pdfft?md5=560511e6fa295949f0480cba2d56a0e8&pid=1-s2.0-S2772687824000606-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141487330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptured middle colic artery aneurysm: A rare vascular presentation in a patient with Still's disease. A systematic literature review","authors":"Immacolata Iannone,&nbsp;Gaia Cicioni,&nbsp;Cristina De Padua,&nbsp;Stefano Arceri,&nbsp;Anna Zhou,&nbsp;Federica Scarno,&nbsp;Eleonora Bruno,&nbsp;Flavia Ciccarone,&nbsp;Marco Assenza","doi":"10.1016/j.avsurg.2024.100306","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100306","url":null,"abstract":"<div><h3>Background</h3><p>Aneurysms of visceral abdominal arteries represent less than 3 % of all splanchnic aneurysms. Pathology is poorly understood but recent studies have focused on the role of inflammation which it can be further enhanced by a systemic inflammatory disease.</p></div><div><h3>Materials and Methods</h3><p>A systematic literature review was conducted to highlight the unsolved aspects of this pathology and a total of 43 patients were retrieved to whom we added 1 patient treated at our Institution.</p></div><div><h3>Results</h3><p>Mean age at presentation was 54 years with a peak of incidence between the 6th and the 7th decades of life. No racial, sex, and age differences were observed among the two groups (<em>P</em>=NS). In 10 (23 %) patients an inflammatory disease was associated. However, the risk of rupture was similar between patients affected with an inflammatory disease and those with a sporadic presentation (<em>P</em>=NS). Color ultrasound was seldomly used but its role is questionable especially in an emergency setting because of the well-known limitations. On the other hand, computed tomography angiogram always permitted diagnosis. Surgery is the treatment of choice to prevent emergent surgery. If feasible, an endovascular approach should be used either in elective or emergent setting. However, hemodynamically unstable patients should be promptly operated on with an open approach. There were 4 (9 %) deaths 1 before surgery, 3 during operation.</p></div><div><h3>Conclusions</h3><p>Although in our revision we were unable to demonstrate that patients affected with an autoimmune diseases or chronic inflammatory conditions might have a higher risk of visceral aneurysm rupture, we recommend a proactive screening approach based on regular monitor of these patients for the presence of visceral aneurysms.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100306"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000588/pdfft?md5=103a404f7d0b5235cda2521028a1129f&pid=1-s2.0-S2772687824000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141487436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}