Vascular and endovascular surgery最新文献

{"title":"A Systematic Review of Single vs Multivessel Recanalisation in Critical Limb Ischaemia.","authors":"Lukschana Senathirajah, Navanith Murali, Angela Lee, Philip Stather, Tariq Ali","doi":"10.1177/15385744261479252","DOIUrl":"https://doi.org/10.1177/15385744261479252","url":null,"abstract":"<p><p>AimTo compare wound healing and amputation free survival outcomes in patients with critical limb threatening ischaemia (CLTI) undergoing single-vessel (SV) vs multi-vessel (MV) crural recanalisation.MethodsElectronic databases including OVID, MEDLINE, Pubmed and CINHAL was conducted up until October 1st, 2024. Eligible studies of all languages included adults with CLTI who underwent SV or MV endovascular revascularisation of the crural vessels and reported wound healing outcomes (primary outcome). Risk of bias was assessed using ROBINS-I and RoB 2 tools. Quality of evidence was assessed using the GRADE System.ResultsA total of 154 articles were screened, of which seven studies (n = 2081 patients; 2402 limbs) were included. Of these, 1520 limbs (63.8%) underwent SV and 882 (36.7%) MV recanalisation. Five studies assessed wound healing across follow-up periods ranging from 3 months to 3 years. No consistent or statistically significant differences in wound healing were found between SV and MV groups. Six studies reported amputation-free survival (AFS) at 1 year, with some showing improved outcomes in MV patients. Overall, the quality of evidence was very low due to high risk of bias, heterogeneity in outcome definitions, and imprecision.ConclusionsThere is no clear evidence that MV recanalisation improves wound healing compared to SV in patients with CLTI. While some studies suggest potential benefits in AFS and limb salvage in selected patients, the current evidence is insufficient to support the added benefit of MV strategies. High-quality randomised trials with standardised outcome reporting are needed.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261479252"},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Repair of a Proximal Paraanastomotic Aneurysm Using the Trombone Technique after Open AAA Repair. A Case Report and Review of the Literature.","authors":"Apostolos G Pitoulias, Kamran Zierke, Nicole Jahr, Mathias Wilhelmi","doi":"10.1177/15385744261479257","DOIUrl":"https://doi.org/10.1177/15385744261479257","url":null,"abstract":"<p><p><b>Background:</b> Paraanastomotic aneurysm after open surgical repair (OSR) for the treatment of abdominal aortic aneurysm (AAA) is a long-term and life threatening complication. Because prior abdominal surgery often makes open reintervention technically challenging, endovascular repair (EVAR) should be considered as an alternative. <b>Case presentation:</b> We report a case of a proximal anastomotic paraanastomotic aneurysm treated by endovascular means using two tube stent grafts deployed in a trombone technique, with prior embolisation of lumbal arteries. Follow-up computed tomography angiography at 1 month demonstrated complete exclusion of the aneurysm with no evidence of a persistent endoleak. <b>Discussion:</b> This case highlights the feasibility and safety of EVAR using the trombone technique for proximal paraanastomotic aneurysms after OSR for AAA. It also underscores the role of pre-emptive lumbar artery embolisation in reducing the risk of type II endoleak and emphasizes the importance of long-term postoperative imaging surveillance to ensure durable outcomes following both open and endovascular aneurysm repair.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261479257"},"PeriodicalIF":0.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuances in Secondary Aortoduodenal Fistula Management: Presentation of Two Cases and Review of the Literature.","authors":"Marianna Mpitou, Zoi Gerasimina Tampouratzi, Evgenia Charitaki, Pavlos Antoniadis, Spiros Delis","doi":"10.1177/15385744261479110","DOIUrl":"https://doi.org/10.1177/15385744261479110","url":null,"abstract":"<p><p>IntroductionSecondary aortoduodenal fistula (SADF) is a rare but life-threatening complication of abdominal aortic aneurysm (AAA) repair, most commonly involving the third or fourth part of the duodenum. Diagnosis is challenging, and management remains controversial.Case PresentationWe report two cases of SADF following open AAA repair. Both patients presented with herald bleed preceding massive gastrointestinal haemorrhage and haemodynamic collapse. Initial stabilisation was achieved with emergency endovascular stent grafting (EVAR). In the first case, the patient underwent definitive two-stage repair with axillobifemoral bypass, graft explantation and duodenectomy with duodenojejunal anastomosis, and remains well at three-year follow-up. The second patient underwent duodenectomy with duodenojejunal anastomosis, but due to severe comorbidities and occluded femoral arteries the aortic graft was left in situ. Despite initial recovery, he developed overwhelming sepsis and died on postoperative day 10.DiscussionThese cases highlight the diagnostic and therapeutic challenges, as well as the complex decision-making required in these patients. Endovascular repair provides life-saving haemostasis and can serve as a bridge to surgery. Definitive management must address both the aortic and duodenal components, tailored to patient comorbidities and anatomy.ConclusionSADF requires prompt recognition and multidisciplinary management. EVAR is invaluable in acute stabilisation, but surgical definitive repair offers the best long-term outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261479110"},"PeriodicalIF":0.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Right True Subclavian Artery Aneurysm Treated With Hybrid Surgery.","authors":"Ioannis Tsouknidas, Melissa Chen Xu, Alec Krosser, Gaurang Joshi, Babak Abai, Michael Nooromid, Paul DiMuzio, Dawn Maria Salvatore","doi":"10.1177/15385744261428747","DOIUrl":"10.1177/15385744261428747","url":null,"abstract":"<p><p><b>Introduction:</b> Subclavian artery (SCA) aneurysms are rare, accounting for less than 1% of peripheral aneurysms. Repair is indicated due to the risk of complications. <b>Methods:</b> The electronic medical records in our institution were reviewed and the case of a patient with large right SCA is presented.<b>Results:</b> An 80 year-old female, with complex medical history, presented with a large right SCA aneurysm. She was deemed high risk for open repair and underwent innominate and common carotid artery stent graft placement, embolization of the sac, and carotid to axillary artery bypass. Her clinical course was complicated by an atheroembolic multiterritorial stroke, and she was found to be clopidogrel resistant. She was discharged to a rehabilitation facility and was recovering well at 3 months after surgery.<b>Conclusion:</b> Detailed and careful pre-operative planning, as well as familiarity with the different surgical approaches is necessary for the best outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"517-523"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147287016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Repair of Huge Twin Aneurysms of Renal Artery and Vein Connected by Arteriovenous Fistula.","authors":"Makoto Toyoda, Hisato Takagi, Tadashi Kitamura","doi":"10.1177/15385744261441931","DOIUrl":"10.1177/15385744261441931","url":null,"abstract":"<p><p>Renal arteriovenous fistula (RAVF) is a rare vascular anomaly, and it becomes exceedingly uncommon when accompanied by a renal vein aneurysm (RVA). While several cases of renal artery aneurysm (RAA) accompanied by RAVF have been sporadically reported, progression from RAA to RAVF and then to RVA has not been previously documented. We present a unique case of a 75-year-old man with chronic kidney disease and hypertension who had a huge RAA and RVA connected by a RAVF. Contrast-enhanced computed tomography revealed an aneurysmal dilation of both the renal artery and renal vein, connected by a high-flow fistulous tract. Given the high risk of rupture and the patient's frailty and comorbidities, endovascular treatment was selected as the initial management strategy. Coil embolization of the renal artery aneurysm was successfully performed, and an aortic extender was deployed using a chimney technique to preserve contralateral renal perfusion. Postoperative imaging demonstrated successful occlusion of the RAA and significant reduction in blood flow through the fistula. During the 3-year follow-up, no enhancement was observed in the RAA, and slight reductions in the size of both the RAA and RVA were noted. To our knowledge, this is the first reported case of a huge RAA and RVA connected by a non-aneurysmal RAVF successfully treated with endovascular therapy, with documented long-term outcomes. This case underscores the feasibility and safety of endovascular intervention in select high-risk patients, even in anatomically complex lesions with high-flow dynamics. As device technology continues to evolve, endovascular repair may increasingly become a first-line option for managing such rare and challenging vascular anomalies.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"540-544"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-Term Comparison of N-Butyl Cyanoacrylate, Endovenous Laser Ablation, and Radiofrequency Ablation for Chronic Venous Insufficiency.","authors":"Ismail Dilek, Alper Selim Kocaoglu, Emre Utkan Büyükceran, Alaaddin Nayman","doi":"10.1177/15385744261441977","DOIUrl":"10.1177/15385744261441977","url":null,"abstract":"<p><p>BackgroundChronic venous insufficiency (CVI) is a prevalent vascular disorder with significant morbidity. Minimally invasive endovenous therapies, including N-butyl cyanoacrylate (NBCA), endovenous laser ablation (EVLA), and radiofrequency ablation (RFA), are widely used, yet comparative mid-term data remain limited. This study aimed to compare these three modalities.MethodsWe retrospectively reviewed 210 patients (70 per group) treated for CVI with NBCA, EVLA, or RFA between January 2018 and June 2022. Inclusion criteria were symptomatic varicose veins classified as CEAP C2-C4b, GSV diameter >5.5 mm, and reflux >0.5 s. The primary endpoint was vein occlusion rate; secondary endpoints included procedure duration, post-procedural pain (VAS) at 6 hours, return to daily activities, complications, and changes in Venous Clinical Severity Score (VCSS). Follow-up was performed at 1 week, 6 months, 12 months, and annually thereafter.ResultsOcclusion rates were high across groups (EVLA 97.1%, RFA 97.1%, NBCA 96.2%; <i>P</i> = 0.595). NBCA had the shortest procedure time (11.9 ± 1.3 min), lowest pain scores (VAS 1.2 ± 0.9), and fastest return to activities (1.1 ± 0.3 days), whereas EVLA showed higher pain scores (VAS 3.3 ± 1.7) and longer recovery (1.7 ± 0.8 days). VCSS improved significantly in all groups at 12 months, with no differences at 24-36 months. Complication rates were low (13.3%), with one deep vein thrombosis in the EVLA group.ConclusionsNBCA, EVLA, and RFA provide effective mid-term occlusion and clinical improvement in CVI. NBCA offers shorter procedure time, lower pain, and faster recovery, while RFA ensures durable outcomes with good tolerance. EVLA remains effective with slightly longer recovery. Technique selection may be guided by clinical context and patient preference.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"492-499"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Kidney Disease Is Associated With a Higher Risk of Complications in Type a Aortic Dissection Repair: A Population Study of National Inpatient Sample From 2015-2020.","authors":"Renxi Li, Deyanira J Prastein, Stephen J Huddleston","doi":"10.1177/15385744261441979","DOIUrl":"10.1177/15385744261441979","url":null,"abstract":"<p><p>BackgroundWhile chronic kidney disease (CKD) has been identified as a risk factor for mortality in patients with aortic diseases, its impact on the outcomes of type A aortic dissection (TAAD) repair has not yet been thoroughly investigated. This study aimed to conduct a comprehensive, population-based analysis of the association of CKD with in-hospital outcomes following TAAD repair.MethodsPatients who underwent TAAD repair were identified in National Inpatient Sample from the last quarter of 2015-2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients with and without CKD while adjusting for demographics, comorbidities, hospital characteristics, primary payer status, and transfer-in status. Additional subgroup analyses compared mild, moderate, and severe CKD patients vs non-CKD patients.ResultsThere were 800 (18.68%) CKD patients and 3482 (81.32%) non-CKD patients who underwent TAAD repair. Patients with and without CKD had comparable in-hospital mortality (aOR = 0.883, 95 CI = 0.671-1.163, <i>P</i> = .38) and there was no difference in the transfer-in status or indication of delay from admission to operation. Patients with CKD had higher risks of major adverse cardiovascular event (MACE; aOR = 1.519, 95 CI = 1.115-2.069, <i>P</i> = .01), myocardial infarction (MI; aOR = 1.693, 95 CI = 1.135-2.524, <i>P</i> = .01), cardiogenic shock (aOR = 1.422, 95 CI = 1.136-1.779, <i>P</i> < 0.01), mechanical ventilation (aOR = 1.346, 95 CI = 1.109-1.634, <i>P</i> < .01), and acute kidney injury (AKI; aOR = 1.933, 95 CI = 1.596-2.343, <i>P</i> < .01). However, CKD patients had a lower rate of pacemaker implantation (aOR = 0.384, 95 CI = 0.167-0.882, <i>P</i> = .02). Subgroup analyses demonstrated that compared to those without CKD, mild-CKD patients had largely comparable outcomes, moderate-CKD patients had higher AKI, and severe-CKD patients had higher cardiac complications.ConclusionCKD is a significant risk factor for postoperative complications following TAAD repair. It is essential to closely monitor and manage organ system complications, particularly cardiac and renal complications, in patients with severe and moderate CKD undergoing TAAD repair.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"500-509"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Management of Tibial Occlusive Disease With Concomitant Metatarsal Pseudoaneurysm and Arteriovenous Fistula in a Diabetic Foot: A Limb Salvage Case.","authors":"Javad Jalili, Ali Akhavi Milani, Sarah Vaseghi, Ramin Pourghorban, Zahra Hakimzadeh, Mehran Malekshoar","doi":"10.1177/15385744261428754","DOIUrl":"10.1177/15385744261428754","url":null,"abstract":"<p><p>BackgroundDiabetic foot ulcers (DFUs) complicated by critical limb ischemia (CLI) present a major therapeutic challenge, especially when associated with chronic total occlusions (CTOs) of below-the-knee (BTK) arteries or vascular lesions such as pedal pseudoaneurysms and arteriovenous fistulas (AVFs). While endovascular techniques have expanded the therapeutic landscape, such anatomically complex cases require tailored, multidisciplinary strategies to achieve successful limb salvage.Case PresentationWe report the case of a 52-year-old male with type II diabetes mellitus, end-stage renal disease (ESRD), and a chronic non-healing DFU. Imaging revealed a CTO of the posterior tibial artery (PTA) and pedal-plantar loop, significant stenosis of the dorsalis pedis artery (DPA), and a distal metatarsal artery pseudoaneurysm with an AVF. The patient underwent successful retrograde endovascular recanalization using the pedal-plantar loop technique and flossing-wire method, followed by balloon angioplasty of the DPA and PTA. Coil embolization of the pseudoaneurysm and AVF was performed using a sandwich technique.OutcomeThe patient experienced no peri-procedural complications. Perfusion parameters improved significantly, and complete wound healing was achieved during follow-up. No recurrence, re-intervention, or amputation occurred within 12 months.ConclusionThis case highlights the feasibility and effectiveness of a fully endovascular, hybrid approach for managing complex BTK occlusions combined with distal vascular lesions. The integration of revascularization and targeted embolization in a single session can optimize outcomes in patients with limb-threatening DFUs.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"529-534"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal Infarction Following Bilateral Common Iliac Artery Stenting: A Rare Case Report.","authors":"Sadullah Şimşek, Tarık Sağlam, Mehmet Salih Karaca","doi":"10.1177/15385744261442188","DOIUrl":"10.1177/15385744261442188","url":null,"abstract":"<p><p>Spinal cord infarction is an uncommon but devastating complication of vascular and endovascular procedures and is rarely reported after iliac artery interventions. We present a 53-year-old woman with severe bilateral common iliac artery stenoses (>90%) who underwent endovascular revascularization via bilateral femoral access with deployment of a terminal aortic covered stent-graft and bilateral \"kissing\" covered common iliac artery stents. The procedure was angiographically successful with restoration of inline aortoiliac flow. Within the first few postoperative hours, the patient developed acute bilateral lower-extremity weakness progressing rapidly to complete paraplegia. Spinal MRI demonstrated long-segment acute ischemia/infarction at the thoracolumbar level (T11-L2) with diffusion restriction and low ADC values. Despite supportive management, there was no neurological recovery during hospitalization, and the patient remained paraplegic at discharge. This case underscores that spinal cord infarction, although exceedingly rare, can occur after aortoiliac stenting, likely related to procedure-associated microembolization and/or compromise of pelvic-paraspinal collateral pathways, and highlights the need for careful pre-procedural risk assessment and vigilant post-procedural neurological monitoring in high-risk patients.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"550-554"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Fenestration Using a Coaxial Wingman Catheter Through Preshaped Guiding Catheter for Revascularization of Abdominal Visceral Branches Originating From False Lumen in Aortic Dissection.","authors":"Satoru Nagatomi, Daigo Kanamori, Hiroshi Yamamoto","doi":"10.1177/15385744261441976","DOIUrl":"10.1177/15385744261441976","url":null,"abstract":"<p><p>IntroductionFollowing thoracic endovascular aortic repair (TEVAR) for aortic dissection, visceral arteries arising from the false lumen may require revascularization when communication between the true and false lumens is naturally occluded or iatrogenically sealed. This study describes an endovascular technique using a Wingman catheter for intimal flap fenestration to establish access for revascularization of abdominal visceral arteries originating from the false lumen.Materials and MethodsA coaxial system was developed by inserting an LRK-shaped catheter within a RE-SS-shaped guiding catheter to maintain shape retention. The Wingman 14C catheter was advanced coaxially through this system to penetrate the intimal flap under biplane fluoroscopic guidance. The created fenestration was dilated with an angioplasty balloon, and this communication pathway was utilized for stent-graft placement to revascularize abdominal visceral arteries arising from the false lumen.ResultsIn 1 patient with type B aortic dissection requiring revascularization of the right renal artery, the coaxial insertion of a Wingman 14C catheter through the preshaped guiding catheter successfully achieved obtuse-angle penetration of the intimal flap without complications. Revascularization of the right renal artery was accomplished, with postoperative imaging demonstrating near-complete false lumen thrombosis and favorable aortic remodeling at 6-month follow-up.ConclusionThis approach represents a useful and safe technique for establishing access to the false lumen in aortic dissection patients when communication between lumens has been eliminated, enabling successful revascularization of visceral arteries originating from the false lumen.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"566-570"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}