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<meta name="DC.Title" content="Transradial Approach for Neuroendovascular Procedures: A Single-Center Review of Safety and Feasibility" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6971" />
<meta name="DC.Date" content="2021-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2021 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In recent years, the transradial approach has become more widely adopted for neuroendovascular procedures. The purpose of this study was to evaluate the safety and feasibility of a transradial approach and distal transradial access for neuroendovascular procedures in a single center.

MATERIALS AND METHODS: Retrospective analysis was performed for all patients who underwent transradial approach or distal transradial access neuroendovascular procedures from January 2016 to August 2019 at a single center. Exclusion criteria included a Barbeau D waveform, a radial artery of &lt;2 mm on sonographic evaluation, and known radial artery occlusion. Procedures were evaluated for technical success (defined as successful radial artery access and completion of the intended procedure without crossover to an auxiliary access site), complications, and adverse events during follow-up at 30 days.

RESULTS: The transradial approach or distal transradial access was attempted in 279 consecutive patients (58.1% women; median age, 57.7 years) who underwent 328 standard or distal transradial approach procedures. Two-hundred seventy-nine transradial approach and 49 distal transradial approach procedures were performed (cerebral angiography [ n  = 213], intracranial intervention [ n  = 64], head and neck intervention [ n  = 30], and stroke intervention [ n  = 21]). Technical success was 92.1%. Immediate adverse events (2.1%) included radial access site hematoma ( n  = 5), radial artery occlusion ( n  = 1), and acute severe radial artery spasm ( n  = 1). Thirty-day adverse events (0.3%) included a radial artery pseudoaneurysm ( n  = 1). Twenty-six cases (7.9%) required crossover to transfemoral access.

CONCLUSIONS: The transradial approach for neuroendovascular procedures is safe and feasible across a wide range of neuroendovascular interventions.

dTRA
:   distal transradial approach
TFA
:   transfemoral approach
TRA
:   transradial approach" />
<meta name="DC.Contributor" content="D.T. Goldman" />
<meta name="DC.Contributor" content="D. Bageac" />
<meta name="DC.Contributor" content="A. Mills" />
<meta name="DC.Contributor" content="B. Yim" />
<meta name="DC.Contributor" content="K. Yaeger" />
<meta name="DC.Contributor" content="S. Majidi" />
<meta name="DC.Contributor" content="C.P. Kellner" />
<meta name="DC.Contributor" content="R.A. De Leacy" />
<meta name="article:published_time" content="2021-02-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Transradial Approach for Neuroendovascular Procedures: A Single-Center Review of Safety and Feasibility" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In recent years, the transradial approach has become more widely adopted for neuroendovascular procedures. The purpose of this study was to evaluate the safety and feasibility of a transradial approach and distal transradial access for neuroendovascular procedures in a single center.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Retrospective analysis was performed for all patients who underwent transradial approach or distal transradial access neuroendovascular procedures from January 2016 to August 2019 at a single center. Exclusion criteria included a Barbeau D waveform, a radial artery of &amp;lt;2 mm on sonographic evaluation, and known radial artery occlusion. Procedures were evaluated for technical success (defined as successful radial artery access and completion of the intended procedure without crossover to an auxiliary access site), complications, and adverse events during follow-up at 30 days.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The transradial approach or distal transradial access was attempted in 279 consecutive patients (58.1% women; median age, 57.7 years) who underwent 328 standard or distal transradial approach procedures. Two-hundred seventy-nine transradial approach and 49 distal transradial approach procedures were performed (cerebral angiography [&lt;i&gt;n&lt;/i&gt; = 213], intracranial intervention [&lt;i&gt;n&lt;/i&gt; = 64], head and neck intervention [&lt;i&gt;n&lt;/i&gt; = 30], and stroke intervention [&lt;i&gt;n&lt;/i&gt; = 21]). Technical success was 92.1%. Immediate adverse events (2.1%) included radial access site hematoma (&lt;i&gt;n&lt;/i&gt; = 5), radial artery occlusion (&lt;i&gt;n&lt;/i&gt; = 1), and acute severe radial artery spasm (&lt;i&gt;n&lt;/i&gt; = 1). Thirty-day adverse events (0.3%) included a radial artery pseudoaneurysm (&lt;i&gt;n&lt;/i&gt; = 1). Twenty-six cases (7.9%) required crossover to transfemoral access.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The transradial approach for neuroendovascular procedures is safe and feasible across a wide range of neuroendovascular interventions.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2021/02/01" />
<meta name="citation_mjid" content="ajnr;42/2/313" />
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<meta name="citation_author" content="D.T. Goldman" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (D.T.G., R.A.D.L.)" />
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<meta name="citation_author" content="D. Bageac" />
<meta name="citation_author_institution" content="bNeurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-4183-2829" />
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<meta name="twitter:title" content="Transradial Approach for Neuroendovascular Procedures: A Single-Center Review of Safety and Feasibility" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In recent years, the transradial approach has become more widely adopted for neuroendovascular procedures. The purpose of this study was to evaluate the safety and feasibility of a transradial approach and distal transradial access for neuroendovascular procedures in a single center.

MATERIALS AND METHODS: Retrospective analysis was performed for all patients who underwent transradial approach or distal transradial access neuroendovascular procedures from January 2016 to August 2019 at a single center. Exclusion criteria included a Barbeau D waveform, a radial artery of &lt;2 mm on sonographic evaluation, and known radial artery occlusion. Procedures were evaluated for technical success (defined as successful radial artery access and completion of the intended procedure without crossover to an auxiliary access site), complications, and adverse events during follow-up at 30 days.

RESULTS: The transradial approach or distal transradial access was attempted in 279 consecutive patients (58.1% women; median age, 57.7 years) who underwent 328 standard or distal transradial approach procedures. Two-hundred seventy-nine transradial approach and 49 distal transradial approach procedures were performed (cerebral angiography [ n  = 213], intracranial intervention [ n  = 64], head and neck intervention [ n  = 30], and stroke intervention [ n  = 21]). Technical success was 92.1%. Immediate adverse events (2.1%) included radial access site hematoma ( n  = 5), radial artery occlusion ( n  = 1), and acute severe radial artery spasm ( n  = 1). Thirty-day adverse events (0.3%) included a radial artery pseudoaneurysm ( n  = 1). Twenty-six cases (7.9%) required crossover to transfemoral access.

CONCLUSIONS: The transradial approach for neuroendovascular procedures is safe and feasible across a wide range of neuroendovascular interventions.

dTRA
:   distal transradial approach
TFA
:   transfemoral approach
TRA
:   transradial approach" />
<meta name="og-title" property="og:title" content="Transradial Approach for Neuroendovascular Procedures: A Single-Center Review of Safety and Feasibility" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/42/2/313" />
<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: In recent years, the transradial approach has become more widely adopted for neuroendovascular procedures. The purpose of this study was to evaluate the safety and feasibility of a transradial approach and distal transradial access for neuroendovascular procedures in a single center.

MATERIALS AND METHODS: Retrospective analysis was performed for all patients who underwent transradial approach or distal transradial access neuroendovascular procedures from January 2016 to August 2019 at a single center. Exclusion criteria included a Barbeau D waveform, a radial artery of &lt;2 mm on sonographic evaluation, and known radial artery occlusion. Procedures were evaluated for technical success (defined as successful radial artery access and completion of the intended procedure without crossover to an auxiliary access site), complications, and adverse events during follow-up at 30 days.

RESULTS: The transradial approach or distal transradial access was attempted in 279 consecutive patients (58.1% women; median age, 57.7 years) who underwent 328 standard or distal transradial approach procedures. Two-hundred seventy-nine transradial approach and 49 distal transradial approach procedures were performed (cerebral angiography [ n  = 213], intracranial intervention [ n  = 64], head and neck intervention [ n  = 30], and stroke intervention [ n  = 21]). Technical success was 92.1%. Immediate adverse events (2.1%) included radial access site hematoma ( n  = 5), radial artery occlusion ( n  = 1), and acute severe radial artery spasm ( n  = 1). Thirty-day adverse events (0.3%) included a radial artery pseudoaneurysm ( n  = 1). Twenty-six cases (7.9%) required crossover to transfemoral access.

CONCLUSIONS: The transradial approach for neuroendovascular procedures is safe and feasible across a wide range of neuroendovascular interventions.

dTRA
:   distal transradial approach
TFA
:   transfemoral approach
TRA
:   transradial approach" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node88774--5" data-node-nid="88774" id="top-node-88774--61095241396" data-pisa="ajnr;42/2/313" data-pisa-master="ajnr;ajnr.A6971" data-apath="/ajnr/42/2/313.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>
  
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      <h1 class="highwire-cite-title" id="page-title">Transradial Approach for Neuroendovascular Procedures: A Single-Center Review of Safety and Feasibility</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">D.T. Goldman</span>, <span class="highwire-citation-author" data-delta="1">D. Bageac</span>, <span class="highwire-citation-author" data-delta="2">A. Mills</span>, <span class="highwire-citation-author" data-delta="3">B. Yim</span>, <span class="highwire-citation-author" data-delta="4">K. Yaeger</span>, <span class="highwire-citation-author" data-delta="5">S. Majidi</span>, <span class="highwire-citation-author" data-delta="6">C.P. Kellner</span> and <span class="highwire-citation-author" data-delta="7">R.A. De Leacy</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">February 2021,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">313-318; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6971 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-88774--61095241396" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">D.T. Goldman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (D.T.G., R.A.D.L.)</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.T.%2BGoldman%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=Goldman%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"><a href="/search/author1%3AD.T.%2BGoldman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4378-6707" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.T. Goldman</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D. Bageac </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York.</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.%2BBageac%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=Bageac%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"><a href="/search/author1%3AD.%2BBageac%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4183-2829" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Bageac</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A. Mills </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York.</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=A.%2BMills%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=Mills%20A&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"><a href="/search/author1%3AA.%2BMills%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-8579-9779" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Mills</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">B. Yim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York.</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=B.%2BYim%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=Yim%20B&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"><a href="/search/author1%3AB.%2BYim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3629-3194" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. Yim</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">K. Yaeger </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York.</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=K.%2BYaeger%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=Yaeger%20K&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"><a href="/search/author1%3AK.%2BYaeger%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7520-4743" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. Yaeger</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">S. Majidi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York.</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=S.%2BMajidi%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=Majidi%20S&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"><a href="/search/author1%3AS.%2BMajidi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2971-6216" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Majidi</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">C.P. Kellner </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York.</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=C.P.%2BKellner%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=Kellner%20C&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"><a href="/search/author1%3AC.P.%2BKellner%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4604-8205" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.P. Kellner</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">R.A. De Leacy </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (D.T.G., R.A.D.L.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (D.B., B.Y., K.Y., S.M., C.P.K., R.A.D.L.), Icahn School of Medicine at Mount Sinai (A.M.), New York, New York.</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=R.A.%2BDe%2BLeacy%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=De%20Leacy%20R&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"><a href="/search/author1%3AR.A.%2BDe%2BLeacy%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9447-5338" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.A. De Leacy</a></li></ul></div></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 42</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2021 </div></div>
      
      
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    	<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">Feb 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">313-318; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6971 </span></div>
  
  
  
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    	<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">Feb 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">313-318; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6971 </span></div>
  
  
  
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