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<meta name="DC.Title" content="Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4364" />
<meta name="DC.Date" content="2015-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Acute basilar occlusions have a poor prognosis without recanalization. Many have underlying severe atherosclerotic intracranial stenosis coexisting with acute thrombosis, requiring treatment of both pathologies in the same session, though technical risks may be encountered. The purpose of this study was to evaluate the technical feasibility and safety of combined treatment by using stent retrievers for the thrombosis, together with angioplasty and stent placement for the underlying stenosis.

MATERIALS AND METHODS: This was a retrospective review of 13 patients with basilar occlusions treated with thrombectomy by the Solitaire stent retriever and angioplasty and intracranial stent placement for underlying severe vertebrobasilar stenosis in the same session. Reperfusion was assessed in terms of the TICI score. Perioperative complications were recorded. Clinical outcomes were assessed by the NIHSS at discharge and the mRS on follow-up at 90 days.

RESULTS: Of the 30 patients with acute basilar artery occlusions treated with stent retrievers during the study period, 18 had coexisting severe intracranial stenosis. Thirteen patients meeting the criteria for our study received combined mechanical thrombectomy and angioplasty with stent placement. The successful recanalization rate was 100%. Distal vessel embolizations occurred in 3 patients. There were 2 mortalities. On discharge, 10 patients (77%) had an improvement in NIHSS of ≥10 points. At 90 days, 6 patients (46%) had a good functional outcome with an mRS of ≤2.

CONCLUSIONS: The combined use of mechanical thrombectomy with angioplasty and stent placement for acute basilar occlusions with underlying severe intracranial atherosclerotic stenosis is technically feasible and safe.

BAO
:   basilar artery occlusion
PTA
:   percutaneous transluminal angioplasty" />
<meta name="DC.Contributor" content="F. Gao" />
<meta name="DC.Contributor" content="W.T. Lo" />
<meta name="DC.Contributor" content="X. Sun" />
<meta name="DC.Contributor" content="D.P. Mo" />
<meta name="DC.Contributor" content="N. Ma" />
<meta name="DC.Contributor" content="Z.R. Miao" />
<meta name="article:published_time" content="2015-10-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Acute basilar occlusions have a poor prognosis without recanalization. Many have underlying severe atherosclerotic intracranial stenosis coexisting with acute thrombosis, requiring treatment of both pathologies in the same session, though technical risks may be encountered. The purpose of this study was to evaluate the technical feasibility and safety of combined treatment by using stent retrievers for the thrombosis, together with angioplasty and stent placement for the underlying stenosis.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;This was a retrospective review of 13 patients with basilar occlusions treated with thrombectomy by the Solitaire stent retriever and angioplasty and intracranial stent placement for underlying severe vertebrobasilar stenosis in the same session. Reperfusion was assessed in terms of the TICI score. Perioperative complications were recorded. Clinical outcomes were assessed by the NIHSS at discharge and the mRS on follow-up at 90 days.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Of the 30 patients with acute basilar artery occlusions treated with stent retrievers during the study period, 18 had coexisting severe intracranial stenosis. Thirteen patients meeting the criteria for our study received combined mechanical thrombectomy and angioplasty with stent placement. The successful recanalization rate was 100%. Distal vessel embolizations occurred in 3 patients. There were 2 mortalities. On discharge, 10 patients (77%) had an improvement in NIHSS of ≥10 points. At 90 days, 6 patients (46%) had a good functional outcome with an mRS of ≤2.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The combined use of mechanical thrombectomy with angioplasty and stent placement for acute basilar occlusions with underlying severe intracranial atherosclerotic stenosis is technically feasible and safe.&lt;/p&gt;" />
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<meta name="twitter:title" content="Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/36/10.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Acute basilar occlusions have a poor prognosis without recanalization. Many have underlying severe atherosclerotic intracranial stenosis coexisting with acute thrombosis, requiring treatment of both pathologies in the same session, though technical risks may be encountered. The purpose of this study was to evaluate the technical feasibility and safety of combined treatment by using stent retrievers for the thrombosis, together with angioplasty and stent placement for the underlying stenosis.

MATERIALS AND METHODS: This was a retrospective review of 13 patients with basilar occlusions treated with thrombectomy by the Solitaire stent retriever and angioplasty and intracranial stent placement for underlying severe vertebrobasilar stenosis in the same session. Reperfusion was assessed in terms of the TICI score. Perioperative complications were recorded. Clinical outcomes were assessed by the NIHSS at discharge and the mRS on follow-up at 90 days.

RESULTS: Of the 30 patients with acute basilar artery occlusions treated with stent retrievers during the study period, 18 had coexisting severe intracranial stenosis. Thirteen patients meeting the criteria for our study received combined mechanical thrombectomy and angioplasty with stent placement. The successful recanalization rate was 100%. Distal vessel embolizations occurred in 3 patients. There were 2 mortalities. On discharge, 10 patients (77%) had an improvement in NIHSS of ≥10 points. At 90 days, 6 patients (46%) had a good functional outcome with an mRS of ≤2.

CONCLUSIONS: The combined use of mechanical thrombectomy with angioplasty and stent placement for acute basilar occlusions with underlying severe intracranial atherosclerotic stenosis is technically feasible and safe.

BAO
:   basilar artery occlusion
PTA
:   percutaneous transluminal angioplasty" />
<meta name="og-title" property="og:title" content="Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/36/10/1947" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Acute basilar occlusions have a poor prognosis without recanalization. Many have underlying severe atherosclerotic intracranial stenosis coexisting with acute thrombosis, requiring treatment of both pathologies in the same session, though technical risks may be encountered. The purpose of this study was to evaluate the technical feasibility and safety of combined treatment by using stent retrievers for the thrombosis, together with angioplasty and stent placement for the underlying stenosis.

MATERIALS AND METHODS: This was a retrospective review of 13 patients with basilar occlusions treated with thrombectomy by the Solitaire stent retriever and angioplasty and intracranial stent placement for underlying severe vertebrobasilar stenosis in the same session. Reperfusion was assessed in terms of the TICI score. Perioperative complications were recorded. Clinical outcomes were assessed by the NIHSS at discharge and the mRS on follow-up at 90 days.

RESULTS: Of the 30 patients with acute basilar artery occlusions treated with stent retrievers during the study period, 18 had coexisting severe intracranial stenosis. Thirteen patients meeting the criteria for our study received combined mechanical thrombectomy and angioplasty with stent placement. The successful recanalization rate was 100%. Distal vessel embolizations occurred in 3 patients. There were 2 mortalities. On discharge, 10 patients (77%) had an improvement in NIHSS of ≥10 points. At 90 days, 6 patients (46%) had a good functional outcome with an mRS of ≤2.

CONCLUSIONS: The combined use of mechanical thrombectomy with angioplasty and stent placement for acute basilar occlusions with underlying severe intracranial atherosclerotic stenosis is technically feasible and safe.

BAO
:   basilar artery occlusion
PTA
:   percutaneous transluminal angioplasty" />
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    <title>Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center | American Journal of Neuroradiology</title>  
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14061--5" data-node-nid="14061" id="top-node-14061--61884002654" data-pisa="ajnr;36/10/1947" data-pisa-master="ajnr;ajnr.A4364" data-apath="/ajnr/36/10/1947.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">INTERVENTIONAL</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A4364" data-atom-uri="/ajnr/36/10/1947.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">F. Gao</span>, <span class="highwire-citation-author" data-delta="1">W.T. Lo</span>, <span class="highwire-citation-author" data-delta="2">X. Sun</span>, <span class="highwire-citation-author" data-delta="3">D.P. Mo</span>, <span class="highwire-citation-author" data-delta="4">N. Ma</span> and <span class="highwire-citation-author" data-delta="5">Z.R. Miao</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1947-1952; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4364 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14061--61884002654" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">F. Gao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BGao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gao%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AF.%2BGao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">W.T. Lo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Medicine (W.T.L.), Queen Elizabeth Hospital, Hong Kong, China.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.T.%2BLo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lo%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AW.T.%2BLo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">X. Sun </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.%2BSun%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sun%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AX.%2BSun%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">D.P. Mo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.P.%2BMo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mo%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.P.%2BMo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">N. Ma </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.%2BMa%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ma%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AN.%2BMa%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Z.R. Miao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.R.%2BMiao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Miao%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AZ.R.%2BMiao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">REFERENCES</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-36.10.1947.1" data-doi="10.1136/jnnp.2004.049924"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 36</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2015 </div></div>
      
      
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      <div class="highwire-cite-title">Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Gao</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">W.T.</span> <span class="nlm-surname">Lo</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Sun</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">D.P.</span> <span class="nlm-surname">Mo</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Ma</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Z.R.</span> <span class="nlm-surname">Miao</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1947-1952; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4364 </span></div>
  
  
  
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      <div class="highwire-cite-title">Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Gao</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">W.T.</span> <span class="nlm-surname">Lo</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Sun</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">D.P.</span> <span class="nlm-surname">Mo</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Ma</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Z.R.</span> <span class="nlm-surname">Miao</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1947-1952; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4364 </span></div>
  
  
  
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