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33 records – page 1 of 4.

The AAA with a challenging neck: outcome of open versus endovascular repair with standard and fenestrated stent-grafts.

https://arctichealth.org/en/permalink/ahliterature88967
Source
J Endovasc Ther. 2009 Apr;16(2):137-46
Publication Type
Article
Date
Apr-2009
Author
Chisci Emiliano
Kristmundsson Thorarinn
de Donato Gianmarco
Resch Timothy
Setacci Francesco
Sonesson Björn
Setacci Carlo
Malina Martin
Author Affiliation
Vascular and Endovascular Surgery Unit, University of Siena, Italy. e.chisci@gmail.com
Source
J Endovasc Ther. 2009 Apr;16(2):137-46
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - radiography - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects - instrumentation - mortality
Female
Humans
Italy
Kaplan-Meiers Estimate
Male
Middle Aged
Odds Ratio
Prosthesis Design
Prosthesis Failure
Reoperation
Retrospective Studies
Risk assessment
Stents
Sweden
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Abstract
PURPOSE: To compare the outcome of endovascular aneurysm repair (EVAR) versus conventional open repair (OR) in patients with a short, angulated or otherwise challenging proximal neck. METHODS: The definition of a challenging proximal neck was based on diameter (>or=28 mm), length (or=60 degrees ), shape (reverse tapered or bulging), and thrombus lining (>50%). Between January 2005 and December 2007, 187 consecutive patients (159 men; mean age 73 years, range 48-92) operated for asymptomatic abdominal aortic aneurysm (AAA) were identified as having challenging proximal neck morphology. Of these, 61 patients were treated with OR at center I (group A), 71 with standard EVAR (group B; 45 center I, 29 center II) and 52 with fenestrated EVAR (group C) at center II. Clinical examination and computed tomography were performed at 1 month and yearly thereafter. RESULTS: There was no statistically significant difference between groups A, B, and C regarding primary technical success rate, 30-day mortality, or late AAA-related mortality. The mean length of follow-up was 19.5 months (range 0-40). Freedom from reintervention at 3 years was 91.8%, 79.7%, and 82.7% for groups A, B, and C, respectively (p = 0.042). The only statistically significant difference between standard and fenestrated EVAR was a higher incidence of late sac expansion [9 (12.2%) versus 1 (1.9%), p = 0.036] in the standard stent-graft group. Reinterventions were more frequent after EVAR (p = NS), but open reinterventions were more common after OR. Reinterventions after EVAR were related to the presence of an angulated (p = 0.039) or short neck (p = 0.024). CONCLUSION: The results of EVAR and OR were similar for AAAs with a challenging proximal neck. Endovascular reinterventions were more frequent after EVAR, particularly in patients with an angulated or short neck. Open reinterventions were more common after OR. More patients and long-term data are needed to confirm these findings.
Notes
Comment In: J Endovasc Ther. 2009 Apr;16(2):147-819456195
PubMed ID
19456190 View in PubMed
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Abdominal aortic embolization of a Figulla atrial septum occluder device, at the level of the celiac axis, after an atrial septal defect closure: hybrid attempt.

https://arctichealth.org/en/permalink/ahliterature98185
Source
Vascular. 2010 Jan-Feb;18(1):59-61
Publication Type
Article
Author
A Kh Jahrome
Peter R Stella
Vanessa J Leijdekkers
Siyrous Hoseyni Guyomi
Frans L Moll
Author Affiliation
Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands. a.k.jahrome@umcutrecht.nl
Source
Vascular. 2010 Jan-Feb;18(1):59-61
Language
English
Publication Type
Article
Keywords
Adult
Aorta, Abdominal - radiography - surgery
Aortic Diseases - etiology - radiography - therapy
Aortography - methods
Catheterization, Peripheral
Device Removal
Embolism - etiology - radiography - surgery - therapy
Female
Foreign-Body Migration - etiology - radiography - surgery - therapy
Heart Catheterization - adverse effects - instrumentation
Heart Septal Defects, Atrial - therapy
Humans
Septal Occluder Device
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures
Abstract
A 41-year-old woman was treated with a Figulla (Occlutec, Helsingborg, Sweden) atrial septum occluder device with no intraprocedural complications. Five months later, dislocation of the device in the abdominal aorta was detected. The occluder device was located at the level of the celiac axis, nearly obstructing the entire aorta. Owing to total incorporation of the device, endoluminal retrieval was not possible. Through a medial rotation approach, the device was safely removed. This is a rare complication after endoluminal closure of an atrial septum defect. The retrieval possibilities are discussed.
PubMed ID
20122364 View in PubMed
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Analysis of aortic wall stress and rupture risk in patients with abdominal aortic aneurysm with a gender perspective.

https://arctichealth.org/en/permalink/ahliterature136255
Source
J Vasc Surg. 2011 Aug;54(2):295-9
Publication Type
Article
Date
Aug-2011
Author
Emma Larsson
Fausto Labruto
T Christian Gasser
Jesper Swedenborg
Rebecka Hultgren
Author Affiliation
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. emma.larsson@ki.se
Source
J Vasc Surg. 2011 Aug;54(2):295-9
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aorta, Abdominal - physiopathology - radiography
Aortic Aneurysm, Abdominal - complications - physiopathology - radiography
Aortic Rupture - etiology - physiopathology - radiography
Aortography - methods
Biomechanical Phenomena
Female
Finite Element Analysis
Humans
Image Interpretation, Computer-Assisted
Male
Middle Aged
Models, Cardiovascular
Retrospective Studies
Risk assessment
Risk factors
Sex Factors
Stress, mechanical
Sweden
Tomography, X-Ray Computed
Abstract
The most commonly used predictor of rupture of an abdominal aortic aneurysm (AAA) is the diameter; however, this does not estimate the true risk for each patient. Why women with AAAs have an increased growth rate, weaker aortic wall, and increased risk for rupture is yet unclear. It is likely that geometrical and biomechanical properties contribute to found gender differences. Several studies have shown that peak wall stress (PWS) and peak wall rupture risk (PWRR), predicted by a finite element (FE) analysis of AAAs derived from computed tomography (CT), is a better predictor of rupture than maximum diameter. The purpose of this study was to investigate if women with AAAs have an increased PWS and PWRR using an FE model compared to men.
Fifteen men and 15 women (AAAs 4-6 cm) were included. AAA geometry was derived from CT scans, and PWS and PWRR were estimated using the FE method. Comparisons were made by t test and Mann-Whitney test.
Mean age (women 73 years old vs men 71 years old) and mean AAA diameter was similar (49.7 mm vs 50.1 mm) for women and men. PWS did not differ for women 184 and men 198 kPa. PWRR was 0.54 (0.28-0.85) for women and 0.43 (0.24-0.66) for men, P = .06.
This is the first analysis of stress and strength of the aneurysm wall with a gender perspective. The reported higher rupture risk for women has previously not been tested with geometrical and biomechanical properties. PWS did not differ, but the PWRR was slightly higher in women. However, the difference did not reach statistical significance, probably due to the small sample size. In summary, the results in the present study suggest that differences in biomechanical properties could be a contributing explanation for the higher rupture risk reported for female patients with AAAs.
PubMed ID
21397436 View in PubMed
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Anatomic feasibility of endovascular reconstruction in aortic arch aneurysms.

https://arctichealth.org/en/permalink/ahliterature261905
Source
Vascular. 2015 Feb;23(1):17-20
Publication Type
Article
Date
Feb-2015
Author
B. Sonesson
M. Landenhed
N. Dias
T. Kristmundsson
R. Ingemansson
B. Koul
M. Malina
T. Resch
Source
Vascular. 2015 Feb;23(1):17-20
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Aged
Aorta, Thoracic - radiography - surgery
Aortic Aneurysm, Thoracic - diagnosis - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - instrumentation
Elective Surgical Procedures
Endovascular Procedures - instrumentation
Feasibility Studies
Female
Humans
Male
Middle Aged
Predictive value of tests
Prosthesis Design
Reconstructive Surgical Procedures - instrumentation
Stents
Sweden
Tomography, X-Ray Computed
Treatment Outcome
Abstract
The purpose was to estimate the proportion of current open aortic arch reconstructions that might be feasible for endovascular repair. From all elective repair made in Southern Sweden in one center between 2005 and 2012, 129 open and eight endovascular aortic arch repairs were identified. The anatomy of the ascending arch and descending aorta as well as the arch vessels was categorized from multiplanar and axial computed tomography scans. Of 129 open cases, only two (1.5%) were suitable for endovascular repair. Among 137 all arch open and endovascular arch reconstructions performed during the study period, only 10 (7%) were candidates for endovascular repair. The most common exclusion for endovascular repair was an excessively large ascending aortic diameter. In conclusion, only a small proportion of patients having an open arch repair are suitable for endovascular arch repair, a finding related to the large diameter of the ascending aorta.
PubMed ID
24621558 View in PubMed
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Aortic dilatation after endovascular repair of blunt traumatic thoracic aortic injuries.

https://arctichealth.org/en/permalink/ahliterature143862
Source
J Vasc Surg. 2010 Jul;52(1):45-8
Publication Type
Article
Date
Jul-2010
Author
Thomas L Forbes
Jeremy R Harris
D Kirk Lawlor
Guy Derose
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre & The University of Western Ontario, London, Ontario, Canada. Tom.Forbes@lhsc.on.ca
Source
J Vasc Surg. 2010 Jul;52(1):45-8
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aorta, Thoracic - injuries - radiography - surgery
Aortic Aneurysm, Thoracic - etiology - radiography
Aortography - methods
Blood Vessel Prosthesis Implantation - adverse effects
Dilatation, Pathologic
Humans
Middle Aged
Ontario
Thoracic Injuries - radiography - surgery
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Wounds, Nonpenetrating - radiography - surgery
Young Adult
Abstract
Endovascular repair of blunt traumatic thoracic aortic injuries (BTAI) has become routine at many trauma centers despite concerns regarding durability and aortic dilatation in these predominantly young patients. These concerns prompted this examination of thoracic aortic expansion after endovascular repair of a BTAI.
The immediate postoperative and most recent computed tomography (CT) scans of patients who had undergone urgent endovascular repair of a BTAI and had at least 1 year of follow-up were reviewed. Diameter measurements were made at four predetermined sites: immediately proximal to the left subclavian artery (D1), immediately distal to the left subclavian artery (D2), distal extent of the endograft (D3), and 15 mm beyond the distal end of the endograft (D4). Split screens permitted direct comparison of measurements between CTs at the corresponding levels.
During a 6-year period (2001-2007), 21 patients (mean age, 42.9 years; range, 19-81 years) underwent endovascular repair of a BTAI, 17 with at least 1 year of follow-up (mean, 2.6 years; range, 1-5.5 years). No patients required reintervention during this period. The mean rate of dilatation for each level of the thoracic aorta in mm/year was: D1, 0.74 (95% confidence interval [CI], 0.42-1.06); D2, 0.83 (95% CI, 0.55-1.11); D3, 0.63 (95% CI, 0.37-0.89); D4, 0.47 (95% CI, 0.27-0.67). The rate of expansion of D2 differed significantly vs D4 (P = .025).
During the first several years of follow-up, the proximal thoracic aorta dilates minimally after endovascular repair of BTAIs, with the segment just distal to the left subclavian artery expanding at a slightly greater rate. Longer-term follow-up is necessary to determine whether this expansion continues and becomes clinically significant.
PubMed ID
20434299 View in PubMed
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Aortic root, not valve, calcification correlates with coronary artery calcification in patients with severe aortic stenosis: A two-center study.

https://arctichealth.org/en/permalink/ahliterature276151
Source
Atherosclerosis. 2015 Dec;243(2):631-7
Publication Type
Article
Date
Dec-2015
Author
Michael Henein
Peter Hällgren
Anders Holmgren
Karen Sörensen
Pranvera Ibrahimi
Klaus Fuglsang Kofoed
Linnea Hornbech Larsen
Christian Hassager
Source
Atherosclerosis. 2015 Dec;243(2):631-7
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aorta - pathology
Aortic Diseases - complications - radiography
Aortic Valve - abnormalities - pathology - radiography
Aortic Valve Stenosis - complications - radiography
Aortography - methods
Calcinosis - complications - radiography
Coronary Angiography - methods
Coronary Artery Disease - complications - radiography
Coronary Stenosis - complications - radiography
Coronary Vessels - radiography
Denmark
Female
Heart Valve Diseases - complications - radiography
Humans
Male
Middle Aged
Multidetector Computed Tomography
Predictive value of tests
Prognosis
Severity of Illness Index
Sweden
Vascular Calcification - complications - radiography
Abstract
The underlying pathology in aortic stenosis (AS) and coronary artery stenosis (CAS) is similar including atherosclerosis and calcification. We hypothesize that coronary artery calcification (CAC) is likely to correlate with aortic root calcification (ARC) rather than with aortic valve calcification (AVC), due to tissue similarity between the two types of vessel rather than with the valve leaflet tissue.
We studied 212 consecutive patients (age 72.5 ± 7.9 years, 91 females) with AS requiring aortic valve replacement (AVR) in two Heart Centers, who underwent multidetector cardiac CT preoperatively. CAC, AVC and ARC were quantified using Agatston scoring. Correlations were tested by Spearman's test and Mann-Whitney U-test was used for comparing different subgroups; bicuspid (BAV) vs tricuspid (TAV) aortic valve.
CAC was present in 92%, AVC in 100% and ARC in 82% of patients. CAC correlated with ARC (rho = 0.51, p 50%), but these were not different in the pattern of calcification from those without CAS. CAC was consistently higher in patients with risk factors for atherosclerosis compared to those without.
The observed relationship between coronary and aortic root calcification suggests a diffuse arterial disease. The lack of relationship between coronary and aortic valve calcification suggests a different pathology.
PubMed ID
26551591 View in PubMed
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Bleeding into the intraluminal thrombus in abdominal aortic aneurysms is associated with rupture.

https://arctichealth.org/en/permalink/ahliterature92160
Source
J Vasc Surg. 2008 Nov;48(5):1108-13
Publication Type
Article
Date
Nov-2008
Author
Roy Joy
Labruto Fausto
Beckman Mats O
Danielson Jesper
Johansson Gunnar
Swedenborg Jesper
Author Affiliation
Department of Surgery, Capio St. Görans Hospital, Stockholm, Sweden. joy.roy@ki.se
Source
J Vasc Surg. 2008 Nov;48(5):1108-13
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - complications - radiography
Aortic Rupture - etiology - radiography
Aortography - methods
Case-Control Studies
Female
Hemorrhage - complications - radiography
Humans
Male
Medical Records Systems, Computerized
Predictive value of tests
Risk factors
Sweden
Thrombosis - complications - radiography
Tomography, X-Ray Computed
Abstract
OBJECTIVE: The aim of this study was to determine signs of bleeding in the intraluminal thrombus and the site of rupture using multislice computed tomography (CT) imaging in patients with abdominal aortic aneurysms (AAA). METHODS: We analyzed CT images of 42 patients with ruptured infrarenal AAA in two hospitals in Stockholm, Sweden during a 3-year period. A "crescent sign" or localized areas with higher attenuation in the thrombus were interpreted as signs of bleeding in the thrombus. A localized area of hyperattenuation did not have the typical crescent shape and was distinguished from calcifications in the thrombus. We measured the attenuation in Hounsfield units in the intraluminal thrombus using CT software to quantify the presence of blood in the thrombus. As controls, we analyzed 36 patients with intact AAA and a comparable aneurysm diameter and age. RESULTS: The crescent sign was more frequent in the ruptured group (38% vs 14%, P = .02), but there was no significant difference in the presence of localized areas of hyperattenuation in the two groups. The attenuation in the thrombus was significantly higher in patients with rupture than in those with intact aneurysms (P = .02). The site of rupture could be localized in 29/42 patients. Ruptures occurred both through the thrombus-covered and the thrombus free wall. In 45% of the patients, the rupture site was localized in the left lateral wall, in 24% in the anterior wall, in 24% in the right lateral wall, but only in 7% in the posterior wall. CONCLUSION: The site of rupture could be identified in a majority of cases of AAA with routine multislice CT. This study demonstrates an association between the presence of blood in the thrombus as suggested by higher attenuation levels and a crescent sign and AAA rupture. If these findings also predict AAA rupture, remains to be established.
PubMed ID
18771882 View in PubMed
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Decreasing prevalence of abdominal aortic aneurysm and changes in cardiovascular risk factors.

https://arctichealth.org/en/permalink/ahliterature282605
Source
J Vasc Surg. 2017 Mar;65(3):651-658
Publication Type
Article
Date
Mar-2017
Author
Sven-Erik Persson
Kurt Boman
Anders Wanhainen
Bo Carlberg
Conny Arnerlöv
Source
J Vasc Surg. 2017 Mar;65(3):651-658
Date
Mar-2017
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - therapeutic use
Aortic Aneurysm, Abdominal - diagnostic imaging - epidemiology - prevention & control
Aortography - methods
Blood pressure
Computed Tomography Angiography
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - blood - drug therapy - epidemiology
Hypertension - drug therapy - epidemiology - physiopathology
Lipids - blood
Male
Mass Screening - methods
Prevalence
Protective factors
Risk factors
Risk Reduction Behavior
Smoking - adverse effects - epidemiology - prevention & control
Sweden - epidemiology
Time Factors
Ultrasonography
Abstract
A significant reduction in the incidence of cardiovascular disease, including abdominal aortic aneurysm (AAA), has been observed in the past decades. In this study, a small but geographically well defined and carefully characterized population, previously screened for AAA and risk factors, was re-examined 11 years later. The aim was to study the reduction of AAA prevalence and associated factors.
All men and women aged 65 to 75 years living in the Norsjö municipality in northern Sweden in January 2010 were invited to an ultrasound examination of the abdominal aorta, registration of body parameters and cardiovascular risk factors, and blood sampling. An AAA was defined as an infrarenal aortic diameter =30 mm. Results were compared with a corresponding investigation conducted in 1999 in the same region.
A total of 602 subjects were invited, of whom 540 (90%) accepted. In 2010, the AAA prevalence was 5.7% (95% confidence interval [CI], 2.8%-8.5%) among men compared with 16.9% (95% CI, 12.3%-21.6%) in 1999 (P 
PubMed ID
27793513 View in PubMed
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Early and long-term outcome after thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection.

https://arctichealth.org/en/permalink/ahliterature138195
Source
Eur J Vasc Endovasc Surg. 2011 Mar;41(3):318-23
Publication Type
Article
Date
Mar-2011
Author
J. Steuer
M-O Eriksson
R. Nyman
M. Björck
A. Wanhainen
Author Affiliation
Institution of Surgical Sciences, Department of Vascular Surgery, Uppsala University, Sweden. johnny.steuer@akademiska.se
Source
Eur J Vasc Endovasc Surg. 2011 Mar;41(3):318-23
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting - mortality - radiography - surgery
Aortic Aneurysm, Thoracic - mortality - radiography - surgery
Aortography - methods
Blood Vessel Prosthesis Implantation - adverse effects - mortality
Endovascular Procedures - adverse effects - mortality
Female
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Paraplegia - etiology
Reoperation
Retrospective Studies
Stroke - etiology
Survival Rate
Sweden
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Abstract
The study aimed to investigate early and long-term outcome of thoracic endovascular aortic repair (TEVAR) for acute complicated type B dissection.
This was a retrospective, single-centre, consecutive case series.
During the period 1999-2009, TEVAR was carried out in 50 patients with non-traumatic acute complicated type B dissection, and in another 10 patients with acute complications, including rupture, end-organ ischaemia and acute dilatation during the primary hospitalisation, but >14 days after onset of symptoms. Thus, in total, 60 patients were included; 22 with a DeBakey type IIIa dissection and 38 with a type IIIb; median age was 67 years. Early (30-day) and long-term (5-year) survival, re-intervention rate and complications were recorded until 1 July 2010.
Within 30 days, two (3%) deaths, one (2%) paraplegia and three (5%) strokes were observed. Five-year survival was 87% and freedom from re-intervention at 5 years was 65%.
In patients with acute complicated type B aortic dissection, TEVAR can be performed with excellent early and long-term survival, whereas morbidity and long-term durability must be further elucidated.
PubMed ID
21194985 View in PubMed
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Early versus late experience in fenestrated endovascular repair for abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature263151
Source
J Vasc Surg. 2015 Apr;61(4):895-901
Publication Type
Article
Date
Apr-2015
Author
Magnus Sveinsson
Jonathan Sobocinski
Timothy Resch
Björn Sonesson
Nuno Dias
Stéphan Haulon
Thorarinn Kristmundsson
Source
J Vasc Surg. 2015 Apr;61(4):895-901
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - diagnosis - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects - instrumentation - methods
Contrast Media - diagnostic use
Endovascular Procedures - adverse effects - instrumentation - methods
Female
France
Humans
Male
Middle Aged
Operative Time
Patient Safety
Patient Selection
Predictive value of tests
Prosthesis Design
Radiation Dosage
Retrospective Studies
Risk factors
Stents
Sweden
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Abstract
The objective of this study was to evaluate operative results and 1-year outcomes in early vs late experience after fenestrated endovascular aortic repair.
All patients treated in Malmö, Sweden, and in Lille, France, with fenestrated endovascular repair for abdominal aortic aneurysm were prospectively enrolled in a computerized database. Early experience was defined as the first 50 patients treated at each center. Data from early and late experience were retrospectively analyzed and compared for differences in operative results and 1-year outcomes.
Early experience covered 4.7 years in Malmö and 4.5 years in Lille; late experience covered 5.6 years in Malmö and 3.7 years in Lille. A total of 288 patients were included. In the later phase, stent graft configuration was more complex because of increased number of fenestrations/scallops incorporated in the graft design (2.7 ± 0.8 vs 3.2 ± 0.7; P
PubMed ID
25595398 View in PubMed
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33 records – page 1 of 4.