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Lin JL, Ji YY, Zhang MZ, Tang Y, Wang RL, Ruan DD, Zhou YF, Wu SJ, Cai SL, Zhang JH, Meng XR, Luo JW, Fang ZT. Rare Cases of Bronchial Aneurysm and Comparison of Interventional Embolization in the Treatment of True Bronchial Aneurysm and Pseudobronchial Aneurysm. Front Cardiovasc Med 2022; 9:856684. [PMID: 35355974 PMCID: PMC8959610 DOI: 10.3389/fcvm.2022.856684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022] Open
Abstract
Background Bronchial artery aneurysm (BAA) is a rare disease. Rupture of BAA can lead to life-threatening hemoptysis, and once diagnosed, treatment is needed regardless of symptoms. Transcatheter artery embolization is the first choice of treatment because it is minimally invasive and effective. This study aimed to retrospectively compare the embolization treatment of a case of true BAA and that of a pseudobranchial aneurysm and explore the choice of embolization method for BAA with short neck or no neck. Materials and Methods Embolization treatment and imaging characteristics of one case of true BAA and one case of pseudobronchial aneurysm admitted to our hospital were analyzed retrospectively. Embolization methods and therapeutic effects of two cases of BAAs were compared. Results Case 1 was that of an intact true BAA inside the mediastinum located at the opening of the bronchial artery. The distal end of the aneurysm was embolized, and tumor cavity was occluded. No recurrence of BAA was found after the operation. Case 2 was that of a ruptured and hemorrhagic pseudobronchial aneurysm of the mediastinum. Coil embolization combined with covered stent graft exclusion of the thoracic aorta were performed, and the left bronchial artery and BAA were almost occluded. Nine months postoperatively, the mediastinal hematoma was almost completely absorbed. Conclusion Endovascular embolization has become the most commonly used for the treatment of BAA. Different methods should be selected according to the location and nature of the aneurysm.
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Affiliation(s)
- Jia-Li Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yuan-Yuan Ji
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Ming-Zhe Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yi Tang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Ruo-Li Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Dan-Dan Ruan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yan-Feng Zhou
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Shao-Jie Wu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Sen-Lin Cai
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Jian-Hui Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Rong Meng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jie-Wei Luo
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- *Correspondence: Jie-Wei Luo,
| | - Zhu-Ting Fang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
- Zhu-Ting Fang,
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Chen Y, Qin W, Zhu Z, Wang X, Yu W, Li F, Li C. Interlocking detachable coil embolization for giant tandem bronchial aneurysms: A case report. Medicine (Baltimore) 2021; 100:e28416. [PMID: 34941187 PMCID: PMC8702262 DOI: 10.1097/md.0000000000028416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/06/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Bronchial artery aneurysm (BAA) is a rare disease that can be life-threatening if it ruptures. Tandem connections of multiple aneurysms are even rarer and more challenging to manage. PATIENT CONCERNS A 46-year-old woman presented to the hospital with intermittent hemoptysis for a week. A bronchial artery computed tomographic angiography scan revealed 2 BAAs associated with bronchial artery-to-pulmonary artery fistulas in the left lung. Three-dimensional CT reconstruction showed 2 bronchial aneurysms in tandem and 1 aneurysm adjacent to the descending aorta. DIAGNOSES Giant tandem bronchial aneurysms were confirmed using computerized tomographic angiography. INTERVENTIONS Nine interlocking detachable coils and 11 standard pushable coils were introduced into aneurysms for embolization. OUTCOMES There was no episodes of hemoptysis. CT angiography indicated that the coils were closely knit and in their proper position 1 month later; at follow-up, the patient had no adverse effects and no recurrence of hemoptysis. LESSONS BAA is a rare disease that can be life-threatening if it ruptures. It should be treated aggressively to determine the presence of symptoms.
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Affiliation(s)
- Yingjie Chen
- School of Medicine, Jianghan University
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
| | - Wei Qin
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Ziyang Zhu
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Xiaojiang Wang
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Wei Yu
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Fajiu Li
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Chenghong Li
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
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Kano M, Nishibe T, Iwahashi T, Fujiyoshi T, Otaka J, Saguchi T, Ogino H. Successful Treatment of Bronchial Artery Aneurysms Associated With Racemose Hemangioma by Combined Therapy of Transcatheter Bronchial Artery Embolization and Thoracic Endovascular Aortic Repair. Vasc Endovascular Surg 2020; 54:540-543. [DOI: 10.1177/1538574420927552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 70-year-old man was referred to our hospital for an abnormal chest shadow. Enhanced computed tomography (CT) revealed 2-humped bronchial artery aneurysms (BAAs) associated with racemose hemangioma. The combined therapy of transcatheter bronchial artery embolization and thoracic endovascular aortic repair was performed. Postoperative CT confirmed the complete exclusion of the aneurysms with no evidence of an endoleak. Our result suggests that this combined therapy is a safe and effective treatment for BAA.
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Affiliation(s)
- Masaki Kano
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshiya Nishibe
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toru Iwahashi
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshiki Fujiyoshi
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan
| | - Jun Otaka
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Toru Saguchi
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan
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Kikutani K, Itai J, Ota K, Chosa K, Yamane Y, Shime N. A Ruptured Mediastinal Bronchial Artery Aneurysm Treated with Urgent Thoracic Endovascular Aortic Repair. Intern Med 2020; 59:1283-1286. [PMID: 32074575 PMCID: PMC7303459 DOI: 10.2169/internalmedicine.4004-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Bronchial artery aneurysms (BAA) are a rare but potentially life-threatening complications because of the massive hemothorax or hemoptysis that occurs with ruptures. A 79-year-old woman was transferred to our hospital because of the sudden onset of back pain, syncope, and subsequent hypotension. Computed tomography showed a left BAA with bilateral hemothorax and hemomediastinum. Transcatheter bronchial artery embolization failed because of the anatomical location, and she went into cardiopulmonary arrest. Cardiopulmonary resuscitation was performed with successful revival. Urgent thoracic endovascular aortic repair to cover the root of the left bronchial artery was successful, and she survived without any neurological deficits.
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Affiliation(s)
- Kazuya Kikutani
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Junji Itai
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Kohei Ota
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Keigo Chosa
- Department of Diagnostic Radiology, Hiroshima University, Japan
| | - Yoshitaka Yamane
- Department of Cardiovascular Surgery, Hiroshima University School of Medicine, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
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Li Y, Gu GC, Liu B, Shao J, Chen Y, Zheng YH. Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review. Vasc Endovascular Surg 2019; 53:492-496. [PMID: 31018831 DOI: 10.1177/1538574419845184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient's cough resolved at 6-month follow-up.
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Affiliation(s)
- Yuan Li
- 1 Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Guang-Chao Gu
- 1 Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Bao Liu
- 1 Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Jiang Shao
- 1 Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yu Chen
- 1 Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yue-Hong Zheng
- 1 Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China
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Nakada T, Takahashi K, Ito E, Fukushima S, Yamamoto S, Takahashi N, Toya N, Akiba T, Morikawa T, Ohki T. A case of bronchial artery aneurysm with an esophageal fistula as an extremely rare complication after bronchial arterial embolization. J Thorac Dis 2018; 10:E476-E480. [PMID: 30069409 DOI: 10.21037/jtd.2018.05.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Takeo Nakada
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Keita Takahashi
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Eisaku Ito
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Soichiro Fukushima
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Seryon Yamamoto
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Naoto Takahashi
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Naoki Toya
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Tadashi Akiba
- Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Toshiaki Morikawa
- Department of Surgery, The Jikei University School of Medicine, Minatoku, Tokyo, Japan
| | - Takao Ohki
- Department of Surgery, The Jikei University School of Medicine, Minatoku, Tokyo, Japan
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San Norberto EM, Urbano García J, Montes JM, Vaquero C. Endovascular treatment of bronchial aneurysms. J Thorac Cardiovasc Surg 2018; 156:e109-e117. [PMID: 29452708 DOI: 10.1016/j.jtcvs.2017.12.121] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 12/10/2017] [Accepted: 12/29/2017] [Indexed: 12/20/2022]
Affiliation(s)
| | - José Urbano García
- Division of Vascular and Interventional Radiology, Jimenez Díaz Foundation University Hospital, Madrid, Spain
| | - José M Montes
- Division of Radiology, Valladolid University Hospital, Valladolid, Spain
| | - Carlos Vaquero
- Division of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain
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8
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Goh Y, Rajendran PC, Loh SEK, Choong AMTL, Ng SJK, Wee B. Transcatheter embolization of a large mediastinal bronchial artery aneurysm with short neck. ANZ J Surg 2017; 89:597-599. [PMID: 28994247 DOI: 10.1111/ans.14198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/30/2017] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Yonggeng Goh
- Department of Interventional Radiology, National University Hospital, Singapore
| | - Prapul C Rajendran
- Department of Interventional Radiology, National University Hospital, Singapore
| | - Stanley E K Loh
- Department of Interventional Radiology, National University Hospital, Singapore
| | | | - Sheldon J K Ng
- Department of Interventional Radiology, National University Hospital, Singapore
| | - Bernard Wee
- Department of Interventional Radiology, National University Hospital, Singapore
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Matsumoto T, Uchida T, Ono T, Hirayama K, Fukumura F, Ando H, Tanaka J. Bronchial Artery Aneurysm Treated Using Aortic Stent Graft Alone: A Case Report. Ann Vasc Dis 2017; 10:152-154. [PMID: 29034044 PMCID: PMC5579770 DOI: 10.3400/avd.cr.16-00091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A 72-year-old woman with a history of malignant lymphoma was referred to our hospital for the treatment of a bronchial artery aneurysm. Computed tomography (CT) scan showed a round, 30 mm-diameter fusiform aneurysm with two tortuous inflow arteries. We deployed thoracic stent grafting to cover the orifice of the two inflow arteries without transcatheter bronchial arterial embolization. Postoperative CT scan revealed complete thrombosis of the aneurysm. Although further follow-up is mandatory, this may be considered a viable treatment option in cases wherein the bronchial artery aneurysm is anatomically difficult to treat.
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Affiliation(s)
- Takashi Matsumoto
- Department of Cardiovascular Surgery, Iizuka Hospital, Fukuoka, Japan
| | - Takayuki Uchida
- Department of Cardiovascular Surgery, Iizuka Hospital, Fukuoka, Japan
| | - Tomoyuki Ono
- Department of Cardiovascular Surgery, Iizuka Hospital, Fukuoka, Japan
| | - Kazuto Hirayama
- Department of Cardiovascular Surgery, Iizuka Hospital, Fukuoka, Japan
| | - Fumio Fukumura
- Department of Cardiovascular Surgery, Iizuka Hospital, Fukuoka, Japan
| | - Hiromi Ando
- Department of Cardiovascular Surgery, Iizuka Hospital, Fukuoka, Japan
| | - Jiro Tanaka
- Department of Cardiovascular Surgery, Iizuka Hospital, Fukuoka, Japan
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10
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Di X, Ji DH, Chen Y, Liu CW, Liu B, Yang J. Endovascular treatment of ectopic bronchial artery aneurysm with brachiocephalic artery stent placement and coil embolization: A case report and literature review. Medicine (Baltimore) 2016; 95:e4461. [PMID: 27583854 PMCID: PMC5008538 DOI: 10.1097/md.0000000000004461] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Bronchial artery aneurysm (BAA) is an uncommon but potentially life-threatening disease, and multiple BAAs are even rarer. Clinically, the tortuous and short neck of a BAA may present significant challenges for invasive intervention. METHODS This report describes the detailed process of diagnosis and treatment and includes a literature review of the etiology, clinical presentation, and therapeutic management of BAA. RESULTS A rare case of multiple BAAs, with one having an inflow artery arising from the brachiocephalic trunk, was referred to our hospital. The patient was successfully treated with coil embolization and brachiocephalic artery stent placement. In addition, we conducted a literature review involving 63 cases of BAA. BAA was most commonly associated with bronchiectasis and was located predominantly in the mediastinum. There was no significant difference between the diameters of the ruptured aneurysms and those of the nonruptured aneurysms (P = 0.115). Transcatheter arterial embolization was the most commonly adopted technique to treat BAA, while thoracic aortic endovascular repair was selected if the neck between the aneurysm and the aorta was short. Subgroup analysis suggested that patients with > 1 BAA were significantly more likely to be female than male (χ test, P = 0.034). CONCLUSION Transcatheter coil embolization combined with stent placement could be a reasonable treatment option for BAAs with a tortuous and short neck. According to our literature review, patients with multiple BAAs display distinctive clinical characteristics compared with patients with a single BAA.
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Affiliation(s)
- Xiao Di
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing
| | - Dong-Hua Ji
- Department of Interventional Therapy, First Affiliated Hospital of Dalian Medical University, Liaoning
| | - Yu Chen
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing
| | - Chang-Wei Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing
| | - Bao Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing
- Correspondence: Bao Liu, Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing 100730, China (e-mail: )
| | - Juan Yang
- Department of Cytobiology, Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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