Catheterization and Cardiovascular Interventions最新文献

{"title":"Catheterization Techniques for Anomalous Aortic Origin of Coronary Arteries.","authors":"Xavier Halna du Fretay, Olivier Boudvillain, Athanasios Koutsoukis, Philippe Degrell, Patrick Dupouy, Pierre Aubry","doi":"10.1002/ccd.31391","DOIUrl":"https://doi.org/10.1002/ccd.31391","url":null,"abstract":"<p><p>Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital anomaly with a large spectrum of anatomical variations. Selective engagement of an AAOCA can present challenges during cardiac catheterization. A comprehensive understanding of the characteristics of major AAOCA can effectively assist operators for selecting and maneuvering catheters. This review outlines the recommended catheter manipulations based on the site of ectopic coronary origin. Identifying the initial course (prepulmonic, subpulmonic, interarterial or retroaortic course) is crucial for classifying each AAOCA. Besides invasive coronary angiography, coronary computed tomography angiography is frequently utilized to enhance the diagnostic assessment. Cardiac catheterization enables the use of intracoronary imaging and physiologic tools for accurately assessing the significance of AAOCA identified as at risk, mainly the anomalies associated with an interarterial course. Intravascular ultrasound is recognized as the gold standard for analyzing AAOCA with interarterial course. Optical tomography coherence imaging can be interesting to evaluate the rare AAOCA with a subpulmonic course, which are associated with ischemic symptoms or myocardial ischemia. Invasive physiological indices using pressure wires can be employed, with the caveat that their threshold values remain uncertain. Decision-making can be challenging for patients with AAOCA. Both non-invasive and invasive imaging tools are essential to support the final choice.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paclitaxel-Coated Balloon for the Management of In-Stent Coronary Restenosis: An Updated Meta-Analysis and Trial Sequential Analysis.","authors":"Vinícius M R Oliveira, Arthur Marot Paiva, Pedro Lucas Alves Alencar, Izadora Caiado Oliveira, João Victor Alves Alencar, Felipe Schmaltz Zalaf, Ricardo Figueiredo Paro Piai, André Maroccolo de Sousa, Humberto Graner Moreira","doi":"10.1002/ccd.31388","DOIUrl":"https://doi.org/10.1002/ccd.31388","url":null,"abstract":"<p><strong>Background: </strong>Drug-coated balloons present a potentially advantageous therapeutic approach for managing coronary in-stent restenosis (ISR). However, the comparative benefits of paclitaxel-coated balloons (PCBs) over uncoated balloons (UCBs) remain unclear.</p><p><strong>Aims: </strong>We conducted a systematic review and meta-analysis to evaluate and compare the clinical outcomes of patients treated with PCBs and UCBs.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane for studies comparing PCBs and UCBs in managing coronary ISR. We used a random-effects model to pool risk ratios (RRs) and their 95% confidence intervals (CIs). Statistical analyses were conducted using Review Manager 5.4.1. Heterogeneity was assessed using I² statistics. Quality and risk of bias were evaluated using the Cochrane Collaboration's tool.</p><p><strong>Results: </strong>We included seven randomized controlled trials with 1349 patients, of whom 840 underwent percutaneous coronary intervention with PCB. In our pooled analysis, patients treated with PCB had lower risks of target lesion revascularization (RR 0.31, 95% CI 0.18-0.52; p < 0.01), target vessel revascularization (0.53, 0.42-0.67; p < 0.01), major adverse cardiac events (MACEs) (0.25, 0.16-0.38; p < 0.01), and myocardial infarction (MI) (0.59, 0.37-0.95; p = 0.03). However, there were no significant differences in all-cause mortality (0.79, 0.37-1.70; p = 0.54), cardiac death (0.46, 0.03-8.12; p = 0.60), while tendencies for a significant difference were found for target lesion failure (0.39, 0.13-1.11; p = 0.08), or stent thrombosis (0.21, 0.03-1.35 p = 0.10).</p><p><strong>Conclusion: </strong>These findings suggest that PCBs are superior to UCBs regarding the occurrence of target lesion revascularization, target vessel revascularization, MACEs, and MI, but they do not differ in all-cause mortality, and cardiac death, while trends to significant differences favoring PCB were found to stent thrombosis and target lesion failure.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Efficiency of Sequential Cutting Balloon Angioplasty in Calcified Coronary Artery Disease: The RODIN-CUT Technique.","authors":"Claudiu Ungureanu, Gregor Leibundgut, Mihai Cocoi, Gabriele Gasparini, Giuseppe Colletti, Alexandre Avran, Enrico Poletti, Alice Moroni, Antonio Mangieri, Silviu Dumitrascu, Abdul Mozid, Marouane Boukhris, Alex Achim, Carlo Zivelonghi, Elias Bentakhou, Pierfrancesco Agostoni","doi":"10.1002/ccd.31387","DOIUrl":"https://doi.org/10.1002/ccd.31387","url":null,"abstract":"<p><strong>Background: </strong>Heavily calcified coronary artery disease presents significant challenges in percutaneous coronary intervention (PCI), often requiring advanced techniques to achieve optimal outcomes. Cutting balloons (CB) have shown potential for plaque modification; however, their effectiveness is limited without standardized protocols.</p><p><strong>Aims: </strong>This study introduces the RODIN-CUT technique, a novel approach utilizing sequential CB inflations with real-time intravascular ultrasound (IVUS) guidance. The technique aims to enhance calcified plaque modification, improve stent expansion, and achieve consistent procedural success in heavily calcified coronary lesions.</p><p><strong>Methodology: </strong>A retrospective analysis of three consecutive patients requiring specialized approaches beyond conventional PCI was included at three centers in Belgium. The RODIN-CUT protocol involved multiple CB inflations at precise lesion segments, followed by immediate IVUS imaging after each inflation to assess plaque modification and guide further therapy. Procedural success was defined as residual stenosis < 30% with TIMI 3 distal flow. The study evaluated the dose-dependent effects of repeated CB inflations on plaque fracture depth and distribution.</p><p><strong>Conclusion: </strong>The RODIN-CUT technique demonstrated promising outcomes, achieving procedural success in all cases with enhanced stent expansion and minimal complications. The technique's simplicity, cost-effectiveness, and reproducibility make it a viable option for treating heavily calcified coronary lesions. Further large-scale studies are required to validate these findings and establish the RODIN-CUT technique as a standard approach for complex calcified lesions.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sheath Type on Vascular and Bleeding Complications After Transcatheter Aortic Valve Replacement: A Post Hoc Analysis From the MARVEL Registry Study.","authors":"Emily Pan, Herbert G Kroon, Pim A L Tonino, Giovanni Amoroso, Mika Laine, Evald H Christiansen, Stefan Toggweiler, Jur Ten Berg, Markus Malmberg, Ton Slagboom, Noriaki Moriyama, Christian J Terkelsen, Federico Moccetti, Livia Gheorghe, Darra Bigelow, John Webb, David Wood, Nicholas Van Mieghem, Mikko Savontaus","doi":"10.1002/ccd.31396","DOIUrl":"https://doi.org/10.1002/ccd.31396","url":null,"abstract":"<p><strong>Background: </strong>Vascular and bleeding complications remain a concern after transfemoral transcatheter aortic valve replacement (TAVR). The impact of the sheath type on these complications remains unclear.</p><p><strong>Methods: </strong>The prospective MARVEL registry study analyzed enrolled 500 patients undergoing large-bore transfemoral procedures and arteriotomy closure with the MANTA vascular closure device from 10 hospitals in Europe and Canada. We stratified these patients according to type of sheath used (expandable or conventional). A propensity-matched analysis was performed using VARC-2 major or minor vascular and bleeding complications as the primary endpoint. The secondary endpoint was time to hemostasis.</p><p><strong>Results: </strong>We identified 196 propensity-matched pairs. Major vascular complications occurred in 3.6% in the expandable sheath group and 4.1% in the conventional sheath group (p = 1.0). Minor vascular complications occurred in 5.6% in the expandable sheath group and 4.6% in the conventional sheath group (p = 0.819). There were no significant differences in bleeding complications between groups. Time to hemostasis after MANTA closure was significantly shorter in the expandable sheath group (30 vs. 60 s, p < 0.001).</p><p><strong>Conclusions: </strong>A propensity-matched analysis demonstrated no significant differences in vascular complication rates with MANTA arteriotomy closure after removal of large bore expandable or conventional sheaths. Time to hemostasis was significantly shorter in the expandable sheath group.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flaring of Protruding Coronary Stents Before Transcatheter Aortic Valve Replacement to Minimize Interaction-A Feasibility Study.","authors":"Jonathan X Fang, Pedro Engel Gonzalez, Pedro A Villablanca, Tiberio M Frisoli, Louie B Kamel-Abusalha, James C Lee, Gennaro Giustino, Dee Dee Wang, William W O'Neill, Brian P O'Neill","doi":"10.1002/ccd.31378","DOIUrl":"https://doi.org/10.1002/ccd.31378","url":null,"abstract":"<p><strong>Background: </strong>Protruding coronary artery stents can adversely affect transcatheter aortic valve replacement (TAVR) procedure. Current evidence on the topic is limited.</p><p><strong>Aims: </strong>We aim to study the clinical feasibility and safety of flaring of protruding coronary artery stents before TAVR to reduce interaction with transcatheter heart valves.</p><p><strong>Methods: </strong>Twenty consecutive patients with 22 protruding coronary stents were optimized with a dual-diameter balloon before TAVR. Procedural success, stent and valve geometry on angiogram, periprocedural and subsequent clinical outcomes as well as valve hemodynamics on echocardiography were evaluated.</p><p><strong>Results: </strong>Procedural success was achieved in 100% of coronary procedure and TAVR without any major complication directly related to the flaring of stents. There was no coronary artery obstruction after TAVR or visible stent or valve deformity. All valves had normal hemodynamics immediately post-deployment with none having clinically significant aortic insufficiency. One patient had inpatient mortality unrelated to coronary stent optimization. One valve had hemodynamic valve degeneration on follow-up which was unrelated to coronary stent flaring and the patient was asymptomatic.</p><p><strong>Conclusion: </strong>Flaring of protruding coronary stents before TAVR is technically feasible and safe and can potentially minimize stent-valve interaction for during of after TAVR.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic vs. Ischemia-Driven Strategies for Percutaneous Coronary Revascularization in Chronic Coronary Syndrome: A Network Meta-Analysis.","authors":"Federico Giacobbe, Eduardo Valente, Giuseppe Giannino, Hiu Ching Yip, Ovidio De Filippo, Francesco Bruno, Federico Conrotto, Mario Iannaccone, Giuseppe Biondi Zoccai, Mauro Gasparini, Javier Escaned, Gaetano Maria De Ferrari, Fabrizio D'Ascenzo","doi":"10.1002/ccd.31331","DOIUrl":"https://doi.org/10.1002/ccd.31331","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with chronic coronary syndromes (CCS), the benefit of percutaneous coronary intervention (PCI) added to optimal medical therapy (OMT) remains unclear. The indication to PCI may be driven either by angiographic evaluation or ischemia assessment, thus depicting different potential strategies which have not yet been thoroughly compared.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) comparing OMT versus PCI angio-guided or versus PCI non-invasive or invasive ischemia guided were identified and compared via network meta-analysis. Major adverse clinical events (MACE), as defined by each included trial, were the primary endpoint, while cardiovascular (CV) death, myocardial infarction (MI), and unplanned revascularization the secondary ones.</p><p><strong>Results: </strong>18 studies, encompassing 17,512 patients, were included, with a mean follow-up of 3.5 years. PCI guided by ischemia defined either invasively or not was associated with a reduced risk of MACE compared with OMT alone. Furthermore, PCI guided by non-invasive assessment of ischemia was associated with a reduced risk of MI compared with OMT (hazard ratio [HR]: 0.61 [95% confidence interval: 0.37-0.94). This strategy ranked best also in preventing CV death. Notably, iFR and FFR guided approaches showed the highest probability of performing best for reduction of subsequent revascularizations.</p><p><strong>Conclusion: </strong>In patients with CCS, ischemia-guided PCI, either by invasive or non-invasive assessment, resulted in a reduced risk of MACE compared with OMT alone. The use of invasive or non-invasive tests influenced the benefit of ischemia-driven PCI: non-invasive tests significantly reduced risk of MI compared with OMT, while iFR or FFR showed the highest probability of reducing the need of subsequent revascularization.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Aortic Valve Replacement in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis.","authors":"Ashraf Ahmed, Rasha Kaddoura, Abhinav Aggarwal, Tawanda Zinyandu, Fabricio Webber, Carlos Davila, Stuart Zarich","doi":"10.1002/ccd.31367","DOIUrl":"https://doi.org/10.1002/ccd.31367","url":null,"abstract":"<p><strong>Background: </strong>The co-existence of severe aortic stenosis (AS) and hypertrophic cardiomyopathy (HCM) is not uncommon. Surgical intervention is the gold standard management. Patients with high surgical risk might undergo transcatheter aortic valve replacement (TAVR). However, TAVR outcomes are unclear in this population. We aimed to investigate the impact of HCM on the outcomes of TAVR.</p><p><strong>Aim: </strong>We aim to investigate the outcomes of TAVR in patients with HCM.</p><p><strong>Methods: </strong>We systematically searched PubMed, EMBASE, and Scopus for studies that compared outcomes of TAVR procedure between patients with HCM and those without it. Using the random-effects model, the odds ratios (OR) with 95% confidence interval (CI) were reported.</p><p><strong>Results: </strong>We screened 102 articles and identified three observational cohort studies. Compared to patients who underwent TAVR without underlying HCM, TAVR for AS co-existed with HCM was associated with higher rates of mortality (OR 5.79; 95% CI: 3.38; 9.91, p < 0.0001), cardiogenic shock (OR 4.55; 95% CI: 3.40; 6.08, p < 0.0001), aortic dissection (OR 4.95; 95% CI: 3.17; 7.74, p < 0.0001), vascular complications (OR 2.10; 95% CI: 1.27; 3.47, p = 0.004), and renal impairment (OR 1.80; 95% CI: 1.36; 2.40, p < 0.0001). There was no difference between the comparison groups in terms of complete heart block, new permanent pacemaker implantation, or bleeding.</p><p><strong>Conclusion: </strong>In patients with severe AS and HCM, TAVR was associated with significantly higher occurrence of mortality, cardiogenic shock, aortic dissection, vascular complications, and renal impairment as well as the need for mechanical ventilation than patients who did not have HCM.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Closure of Sub-Annular Rupture Following Transcatheter Aortic Valve Replacement Complicated by Severe Tricuspid Regurgitation.","authors":"Laurent Faroux, Marina Urena-Alcazar, Aurélien Villecourt, Fanny Boyer","doi":"10.1002/ccd.31400","DOIUrl":"https://doi.org/10.1002/ccd.31400","url":null,"abstract":"<p><p>Aortic annular rupture is a rare and usually fatal complication of TAVR. We report the case of a sub-annular aortic rupture contained in the right ventricle and percutaneously repaired. The procedure was complicated by new-onset severe tricuspid regurgitation related to tricuspid injury during wire externalization and immediately treated by transcatheter edge-to-edge repair.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction in the United States.","authors":"Chayakrit Krittanawong, Song Peng Ang, Neil Sagar Maitra, Zhen Wang, Mahboob Alam, Hani Jneid, Samin Sharma","doi":"10.1002/ccd.31389","DOIUrl":"https://doi.org/10.1002/ccd.31389","url":null,"abstract":"<p><strong>Background: </strong>The role of Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) is still unclear in patients with STEMI undergoing PCI in the current second-generation DES era.</p><p><strong>Aims: </strong>This study aimed to evaluate the trends and outcomes of IVUS-guided PCI in patients with STEMI.</p><p><strong>Methods: </strong>We used the National Inpatient Sample (NIS) database from 2016 to 2021. The primary endpoint of this study is all-cause in-hospital mortality. Secondary endpoints include trends of PCI hospitalizations, trends of mortality, length of stay, and cost of hospitalization.</p><p><strong>Results: </strong>There were data for 819,645 hospitalizations for STEMI, of which 91.2% (n = 74,7860) utilized angiography-guided PCI, 8.4% (n = 68,985) utilized IVUS-guided PCI and 0.3% (n = 2800) utilized OCT-guided PCI. In-hospital mortality for IVUS-guided PCI was 4.6% (n = 3190) versus 6.0% (n = 44,935) for angiography-guided PCI with an adjusted OR 0.75 (0.68-0.81, p < 0.001). In-hospital mortality for OCT-guided PCI was 3.4% (n = 95) versus 6.0% (n = 44,935) for angiography-guided PCI with an adjusted OR 0.67 (0.43-1.06, p = 0.09).</p><p><strong>Conclusions: </strong>IVUS/OCT-guidance was increasingly utilized over the years and was associated with a significantly reduced adjusted odds of in-hospital mortality. Large-scale, long-term randomized data are needed to better ascertain where IVUS/OCT may be best utilized for optimization of PCI for STEMI.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular Lithotripsy: A Promising Treatment for Calcified Lesions in Acute Coronary Syndromes.","authors":"M Chadi Alraies, Jawad Basit","doi":"10.1002/ccd.31365","DOIUrl":"https://doi.org/10.1002/ccd.31365","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}