Incidence, mechanisms, treatment, and outcomes of donor vessel injury during percutaneous coronary interventions for chronic total occlusion
Donor vessel injury is a potentially life-threatening complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Our goal was to examine the incidence, mechanisms, treatment, and outcomes of patients with donor vessel injury in a large multicenter CTO PCI registry. We an...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2023-10, Vol.102 (4), p.585-593 |
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| creator | Kostantinis, Spyridon Rempakos, Athanasios Simsek, Bahadir Karacsonyi, Judit Allana, Salman S Alaswad, Khaldoon Basir, Mir B Krestyaninov, Oleg Khelimskii, Dmitrii Gorgulu, Sevket Davies, Rhian E Benton, Stewart M Khatri, Jaikirshan J Poommipanit, Paul Choi, James W Jaber, Wissam A Rinfret, Stephane Nicholson, William Al-Azizi, Karim M Potluri, Srinivasa Aygul, Nazif Altunkeser, Bulent B Koutouzis, Michael Tsiafoutis, Ioannis Milkas, Anastasios ElGuindy, Ahmed M Abi Rafeh, Nidal Goktekin, Omer Mastrodemos, Olga C Rangan, Bavana V Sandoval, Yader Burke, M Nicholas Brilakis, Emmanouil S |
| description | Donor vessel injury is a potentially life-threatening complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Our goal was to examine the incidence, mechanisms, treatment, and outcomes of patients with donor vessel injury in a large multicenter CTO PCI registry.
We analyzed the baseline clinical and angiographic characteristics, and procedural outcomes of 12,349 CTO PCIs performed between 2012 and 2022 at 44 centers.
The incidence of donor vessel injury was 0.35% (n = 43). The baseline clinical characteristics of patients with and without donor vessel injury were similar. Cases complicated by donor vessel injury were more complex with higher Japanese CTO score (2.9 ± 1.1 vs. 2.4 ± 1.3; p = 0.004) and lower procedural success rate (69.8% vs. 85.2%; p = 0.004). The retrograde approach was used more commonly in donor vessel injury cases (68.9% vs. 30.9%; p |
| doi_str_mv | 10.1002/ccd.30798 |
| format | Article |
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Our goal was to examine the incidence, mechanisms, treatment, and outcomes of patients with donor vessel injury in a large multicenter CTO PCI registry.
We analyzed the baseline clinical and angiographic characteristics, and procedural outcomes of 12,349 CTO PCIs performed between 2012 and 2022 at 44 centers.
The incidence of donor vessel injury was 0.35% (n = 43). The baseline clinical characteristics of patients with and without donor vessel injury were similar. Cases complicated by donor vessel injury were more complex with higher Japanese CTO score (2.9 ± 1.1 vs. 2.4 ± 1.3; p = 0.004) and lower procedural success rate (69.8% vs. 85.2%; p = 0.004). The retrograde approach was used more commonly in donor vessel injury cases (68.9% vs. 30.9%; p < 0.001). Most (53.5%) donor vessel injuries were guide catheter-induced, whereas 20.9% were due to donor vessel thrombosis. Of the 43 patients with donor vessel injury, 36 (83.7%) were treated with stenting and seven (16.3%) received a left ventricular assist device. The incidence of major adverse cardiovascular events (MACEs) was significantly higher in cases with donor vessel injury (23.3% vs. 2.0%; p < 0.001). Of the 43 patients with donor vessel injury, five patients (11.6%) experienced acute myocardial infarction and four patients (9.3%) died.
Donor vessel injury, occurred in 0.35% of CTO PCIs performed by experienced operators, was mainly due to guide catheter-induced dissection or thrombosis and was associated with lower procedural success and higher MACE.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.30798</identifier><identifier>PMID: 37560823</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Catheters ; Heart ; Myocardial infarction ; Occlusion ; Patients ; Thrombosis ; Ventricle</subject><ispartof>Catheterization and cardiovascular interventions, 2023-10, Vol.102 (4), p.585-593</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c273t-792dfc49ae541a29b98d976d5db60044fca317dbb9ba72145983321ded65c1af3</cites><orcidid>0000-0003-1099-681X ; 0000-0001-6198-8006 ; 0000-0003-0195-4984 ; 0000-0001-9416-9701 ; 0000-0003-4775-1402 ; 0000-0003-1069-2437 ; 0000-0002-0315-3219 ; 0000-0001-7835-793X ; 0000-0003-4800-2972 ; 0000-0002-6991-7621 ; 0000-0003-3486-6753 ; 0000-0001-5419-913X ; 0000-0002-2884-7778 ; 0000-0002-2683-5255</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37560823$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kostantinis, Spyridon</creatorcontrib><creatorcontrib>Rempakos, Athanasios</creatorcontrib><creatorcontrib>Simsek, Bahadir</creatorcontrib><creatorcontrib>Karacsonyi, Judit</creatorcontrib><creatorcontrib>Allana, Salman S</creatorcontrib><creatorcontrib>Alaswad, Khaldoon</creatorcontrib><creatorcontrib>Basir, Mir B</creatorcontrib><creatorcontrib>Krestyaninov, Oleg</creatorcontrib><creatorcontrib>Khelimskii, Dmitrii</creatorcontrib><creatorcontrib>Gorgulu, Sevket</creatorcontrib><creatorcontrib>Davies, Rhian E</creatorcontrib><creatorcontrib>Benton, Stewart M</creatorcontrib><creatorcontrib>Khatri, Jaikirshan J</creatorcontrib><creatorcontrib>Poommipanit, Paul</creatorcontrib><creatorcontrib>Choi, James W</creatorcontrib><creatorcontrib>Jaber, Wissam A</creatorcontrib><creatorcontrib>Rinfret, Stephane</creatorcontrib><creatorcontrib>Nicholson, William</creatorcontrib><creatorcontrib>Al-Azizi, Karim M</creatorcontrib><creatorcontrib>Potluri, Srinivasa</creatorcontrib><creatorcontrib>Aygul, Nazif</creatorcontrib><creatorcontrib>Altunkeser, Bulent B</creatorcontrib><creatorcontrib>Koutouzis, Michael</creatorcontrib><creatorcontrib>Tsiafoutis, Ioannis</creatorcontrib><creatorcontrib>Milkas, Anastasios</creatorcontrib><creatorcontrib>ElGuindy, Ahmed M</creatorcontrib><creatorcontrib>Abi Rafeh, Nidal</creatorcontrib><creatorcontrib>Goktekin, Omer</creatorcontrib><creatorcontrib>Mastrodemos, Olga C</creatorcontrib><creatorcontrib>Rangan, Bavana V</creatorcontrib><creatorcontrib>Sandoval, Yader</creatorcontrib><creatorcontrib>Burke, M Nicholas</creatorcontrib><creatorcontrib>Brilakis, Emmanouil S</creatorcontrib><title>Incidence, mechanisms, treatment, and outcomes of donor vessel injury during percutaneous coronary interventions for chronic total occlusion</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Donor vessel injury is a potentially life-threatening complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Our goal was to examine the incidence, mechanisms, treatment, and outcomes of patients with donor vessel injury in a large multicenter CTO PCI registry.
We analyzed the baseline clinical and angiographic characteristics, and procedural outcomes of 12,349 CTO PCIs performed between 2012 and 2022 at 44 centers.
The incidence of donor vessel injury was 0.35% (n = 43). The baseline clinical characteristics of patients with and without donor vessel injury were similar. Cases complicated by donor vessel injury were more complex with higher Japanese CTO score (2.9 ± 1.1 vs. 2.4 ± 1.3; p = 0.004) and lower procedural success rate (69.8% vs. 85.2%; p = 0.004). The retrograde approach was used more commonly in donor vessel injury cases (68.9% vs. 30.9%; p < 0.001). Most (53.5%) donor vessel injuries were guide catheter-induced, whereas 20.9% were due to donor vessel thrombosis. Of the 43 patients with donor vessel injury, 36 (83.7%) were treated with stenting and seven (16.3%) received a left ventricular assist device. The incidence of major adverse cardiovascular events (MACEs) was significantly higher in cases with donor vessel injury (23.3% vs. 2.0%; p < 0.001). Of the 43 patients with donor vessel injury, five patients (11.6%) experienced acute myocardial infarction and four patients (9.3%) died.
Donor vessel injury, occurred in 0.35% of CTO PCIs performed by experienced operators, was mainly due to guide catheter-induced dissection or thrombosis and was associated with lower procedural success and higher MACE.</description><subject>Catheters</subject><subject>Heart</subject><subject>Myocardial infarction</subject><subject>Occlusion</subject><subject>Patients</subject><subject>Thrombosis</subject><subject>Ventricle</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpdkctqFUEQhhtRzEUXvoA0uIlwTuzbTE8vJcQYCLhRcDf0VNeYPsx0H_sSyDv40Laeo4usquD_6qeqfkLecHbJGRMfANylZNoMz8gp74TYatF_f37suVH9CTnLeccYM70wL8mJ1F3PBiFPya_bAN5hANzQFeHeBp_XvKEloS0rhrKhNjgaa4G4YqZxpi6GmOgD5owL9WFX0yN1Nfnwg-4xQS02YKyZQkwx2Cb6UDA9NC8fQ6ZzG4b7JnmgJRa70Aiw1NzEV-TFbJeMr4_1nHz7dP316vP27svN7dXHuy0ILctWG-FmUMZip7gVZjKDM7p3nZt6xpSawUqu3TSZyWrBVWcGKQV36PoOuJ3lObk4-O5T_Fkxl3H1GXBZDpuPYlDDoATTuqHvnqC7WFNo2zWqvZkPuleNen-gIMWcE87jPvm13T5yNv6JaGwRjX8jauzbo2OdVnT_yX-ZyN-Vpo9I</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Kostantinis, Spyridon</creator><creator>Rempakos, Athanasios</creator><creator>Simsek, Bahadir</creator><creator>Karacsonyi, Judit</creator><creator>Allana, Salman S</creator><creator>Alaswad, Khaldoon</creator><creator>Basir, Mir B</creator><creator>Krestyaninov, Oleg</creator><creator>Khelimskii, Dmitrii</creator><creator>Gorgulu, Sevket</creator><creator>Davies, Rhian E</creator><creator>Benton, Stewart M</creator><creator>Khatri, Jaikirshan J</creator><creator>Poommipanit, Paul</creator><creator>Choi, James W</creator><creator>Jaber, Wissam A</creator><creator>Rinfret, Stephane</creator><creator>Nicholson, William</creator><creator>Al-Azizi, Karim M</creator><creator>Potluri, Srinivasa</creator><creator>Aygul, Nazif</creator><creator>Altunkeser, Bulent B</creator><creator>Koutouzis, Michael</creator><creator>Tsiafoutis, Ioannis</creator><creator>Milkas, Anastasios</creator><creator>ElGuindy, Ahmed M</creator><creator>Abi Rafeh, Nidal</creator><creator>Goktekin, Omer</creator><creator>Mastrodemos, Olga C</creator><creator>Rangan, Bavana V</creator><creator>Sandoval, Yader</creator><creator>Burke, M Nicholas</creator><creator>Brilakis, Emmanouil S</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1099-681X</orcidid><orcidid>https://orcid.org/0000-0001-6198-8006</orcidid><orcidid>https://orcid.org/0000-0003-0195-4984</orcidid><orcidid>https://orcid.org/0000-0001-9416-9701</orcidid><orcidid>https://orcid.org/0000-0003-4775-1402</orcidid><orcidid>https://orcid.org/0000-0003-1069-2437</orcidid><orcidid>https://orcid.org/0000-0002-0315-3219</orcidid><orcidid>https://orcid.org/0000-0001-7835-793X</orcidid><orcidid>https://orcid.org/0000-0003-4800-2972</orcidid><orcidid>https://orcid.org/0000-0002-6991-7621</orcidid><orcidid>https://orcid.org/0000-0003-3486-6753</orcidid><orcidid>https://orcid.org/0000-0001-5419-913X</orcidid><orcidid>https://orcid.org/0000-0002-2884-7778</orcidid><orcidid>https://orcid.org/0000-0002-2683-5255</orcidid></search><sort><creationdate>20231001</creationdate><title>Incidence, mechanisms, treatment, and outcomes of donor vessel injury during percutaneous coronary interventions for chronic total occlusion</title><author>Kostantinis, Spyridon ; Rempakos, Athanasios ; Simsek, Bahadir ; Karacsonyi, Judit ; Allana, Salman S ; Alaswad, Khaldoon ; Basir, Mir B ; Krestyaninov, Oleg ; Khelimskii, Dmitrii ; Gorgulu, Sevket ; Davies, Rhian E ; Benton, Stewart M ; Khatri, Jaikirshan J ; Poommipanit, Paul ; Choi, James W ; Jaber, Wissam A ; Rinfret, Stephane ; Nicholson, William ; Al-Azizi, Karim M ; Potluri, Srinivasa ; Aygul, Nazif ; Altunkeser, Bulent B ; Koutouzis, Michael ; Tsiafoutis, Ioannis ; Milkas, Anastasios ; ElGuindy, Ahmed M ; Abi Rafeh, Nidal ; Goktekin, Omer ; Mastrodemos, Olga C ; Rangan, Bavana V ; Sandoval, Yader ; Burke, M Nicholas ; Brilakis, Emmanouil S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c273t-792dfc49ae541a29b98d976d5db60044fca317dbb9ba72145983321ded65c1af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Catheters</topic><topic>Heart</topic><topic>Myocardial infarction</topic><topic>Occlusion</topic><topic>Patients</topic><topic>Thrombosis</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kostantinis, Spyridon</creatorcontrib><creatorcontrib>Rempakos, Athanasios</creatorcontrib><creatorcontrib>Simsek, Bahadir</creatorcontrib><creatorcontrib>Karacsonyi, Judit</creatorcontrib><creatorcontrib>Allana, Salman S</creatorcontrib><creatorcontrib>Alaswad, Khaldoon</creatorcontrib><creatorcontrib>Basir, Mir B</creatorcontrib><creatorcontrib>Krestyaninov, Oleg</creatorcontrib><creatorcontrib>Khelimskii, Dmitrii</creatorcontrib><creatorcontrib>Gorgulu, Sevket</creatorcontrib><creatorcontrib>Davies, Rhian E</creatorcontrib><creatorcontrib>Benton, Stewart M</creatorcontrib><creatorcontrib>Khatri, Jaikirshan J</creatorcontrib><creatorcontrib>Poommipanit, Paul</creatorcontrib><creatorcontrib>Choi, James W</creatorcontrib><creatorcontrib>Jaber, Wissam A</creatorcontrib><creatorcontrib>Rinfret, Stephane</creatorcontrib><creatorcontrib>Nicholson, William</creatorcontrib><creatorcontrib>Al-Azizi, Karim M</creatorcontrib><creatorcontrib>Potluri, Srinivasa</creatorcontrib><creatorcontrib>Aygul, Nazif</creatorcontrib><creatorcontrib>Altunkeser, Bulent B</creatorcontrib><creatorcontrib>Koutouzis, Michael</creatorcontrib><creatorcontrib>Tsiafoutis, Ioannis</creatorcontrib><creatorcontrib>Milkas, Anastasios</creatorcontrib><creatorcontrib>ElGuindy, Ahmed M</creatorcontrib><creatorcontrib>Abi Rafeh, Nidal</creatorcontrib><creatorcontrib>Goktekin, Omer</creatorcontrib><creatorcontrib>Mastrodemos, Olga C</creatorcontrib><creatorcontrib>Rangan, Bavana V</creatorcontrib><creatorcontrib>Sandoval, Yader</creatorcontrib><creatorcontrib>Burke, M Nicholas</creatorcontrib><creatorcontrib>Brilakis, Emmanouil S</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kostantinis, Spyridon</au><au>Rempakos, Athanasios</au><au>Simsek, Bahadir</au><au>Karacsonyi, Judit</au><au>Allana, Salman S</au><au>Alaswad, Khaldoon</au><au>Basir, Mir B</au><au>Krestyaninov, Oleg</au><au>Khelimskii, Dmitrii</au><au>Gorgulu, Sevket</au><au>Davies, Rhian E</au><au>Benton, Stewart M</au><au>Khatri, Jaikirshan J</au><au>Poommipanit, Paul</au><au>Choi, James W</au><au>Jaber, Wissam A</au><au>Rinfret, Stephane</au><au>Nicholson, William</au><au>Al-Azizi, Karim M</au><au>Potluri, Srinivasa</au><au>Aygul, Nazif</au><au>Altunkeser, Bulent B</au><au>Koutouzis, Michael</au><au>Tsiafoutis, Ioannis</au><au>Milkas, Anastasios</au><au>ElGuindy, Ahmed M</au><au>Abi Rafeh, Nidal</au><au>Goktekin, Omer</au><au>Mastrodemos, Olga C</au><au>Rangan, Bavana V</au><au>Sandoval, Yader</au><au>Burke, M Nicholas</au><au>Brilakis, Emmanouil S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, mechanisms, treatment, and outcomes of donor vessel injury during percutaneous coronary interventions for chronic total occlusion</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>102</volume><issue>4</issue><spage>585</spage><epage>593</epage><pages>585-593</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Donor vessel injury is a potentially life-threatening complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Our goal was to examine the incidence, mechanisms, treatment, and outcomes of patients with donor vessel injury in a large multicenter CTO PCI registry.
We analyzed the baseline clinical and angiographic characteristics, and procedural outcomes of 12,349 CTO PCIs performed between 2012 and 2022 at 44 centers.
The incidence of donor vessel injury was 0.35% (n = 43). The baseline clinical characteristics of patients with and without donor vessel injury were similar. Cases complicated by donor vessel injury were more complex with higher Japanese CTO score (2.9 ± 1.1 vs. 2.4 ± 1.3; p = 0.004) and lower procedural success rate (69.8% vs. 85.2%; p = 0.004). The retrograde approach was used more commonly in donor vessel injury cases (68.9% vs. 30.9%; p < 0.001). Most (53.5%) donor vessel injuries were guide catheter-induced, whereas 20.9% were due to donor vessel thrombosis. Of the 43 patients with donor vessel injury, 36 (83.7%) were treated with stenting and seven (16.3%) received a left ventricular assist device. The incidence of major adverse cardiovascular events (MACEs) was significantly higher in cases with donor vessel injury (23.3% vs. 2.0%; p < 0.001). Of the 43 patients with donor vessel injury, five patients (11.6%) experienced acute myocardial infarction and four patients (9.3%) died.
Donor vessel injury, occurred in 0.35% of CTO PCIs performed by experienced operators, was mainly due to guide catheter-induced dissection or thrombosis and was associated with lower procedural success and higher MACE.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37560823</pmid><doi>10.1002/ccd.30798</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1099-681X</orcidid><orcidid>https://orcid.org/0000-0001-6198-8006</orcidid><orcidid>https://orcid.org/0000-0003-0195-4984</orcidid><orcidid>https://orcid.org/0000-0001-9416-9701</orcidid><orcidid>https://orcid.org/0000-0003-4775-1402</orcidid><orcidid>https://orcid.org/0000-0003-1069-2437</orcidid><orcidid>https://orcid.org/0000-0002-0315-3219</orcidid><orcidid>https://orcid.org/0000-0001-7835-793X</orcidid><orcidid>https://orcid.org/0000-0003-4800-2972</orcidid><orcidid>https://orcid.org/0000-0002-6991-7621</orcidid><orcidid>https://orcid.org/0000-0003-3486-6753</orcidid><orcidid>https://orcid.org/0000-0001-5419-913X</orcidid><orcidid>https://orcid.org/0000-0002-2884-7778</orcidid><orcidid>https://orcid.org/0000-0002-2683-5255</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1522-1946 |
| ispartof | Catheterization and cardiovascular interventions, 2023-10, Vol.102 (4), p.585-593 |
| issn | 1522-1946 1522-726X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2848842077 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Catheters Heart Myocardial infarction Occlusion Patients Thrombosis Ventricle |
| title | Incidence, mechanisms, treatment, and outcomes of donor vessel injury during percutaneous coronary interventions for chronic total occlusion |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T20%3A12%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Incidence,%20mechanisms,%20treatment,%20and%20outcomes%20of%20donor%20vessel%20injury%20during%20percutaneous%20coronary%20interventions%20for%20chronic%20total%20occlusion&rft.jtitle=Catheterization%20and%20cardiovascular%20interventions&rft.au=Kostantinis,%20Spyridon&rft.date=2023-10-01&rft.volume=102&rft.issue=4&rft.spage=585&rft.epage=593&rft.pages=585-593&rft.issn=1522-1946&rft.eissn=1522-726X&rft_id=info:doi/10.1002/ccd.30798&rft_dat=%3Cproquest_cross%3E2872618764%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2872618764&rft_id=info:pmid/37560823&rfr_iscdi=true |