Implementation of Transcatheter Aortic Valve Replacement in France
Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR), but unbiased data regarding evolution of the treatment of patients with aortic stenosis at the nationwide level are scarce. This study sought to evaluate the number of aortic valv...
Uloženo v:
| Vydáno v: | Journal of the American College of Cardiology Ročník 71; číslo 15; s. 1614 |
|---|---|
| Hlavní autoři: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
17.04.2018
|
| Témata: | |
| ISSN: | 1558-3597, 1558-3597 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR), but unbiased data regarding evolution of the treatment of patients with aortic stenosis at the nationwide level are scarce.
This study sought to evaluate the number of aortic valve replacements (AVRs) performed in France, changes over time, and the effect of the adoption of TAVR.
Based on a French administrative hospital-discharge database, the study collected all consecutive AVRs performed in France between 2007 and 2015.
A total of 131,251 interventions were performed: 109,317 (83%) SAVR and 21,934 (17%) TAVR. AVR linearly increased (from 10,892 to 18,704; p for trend <0.0001) mainly due to a marked increase in TAVR (from 244 to 6,722; p for trend = 0.0004), whereas SAVR remained stable (from 10,892 to 11,982; p for trend = 0.18). Parallel to a decrease in the Charlson index (p for trend <0.05), SAVR and TAVR in-hospital mortality rates significantly declined (both p for trend <0.01). The number of TAVRs significantly increased in all age categories (<75, 75 to 79, 80 to 84, and ≥85 years of age; all p for trend = 0.003), but reached or even exceeded SAVR in the 2 oldest categories. Although mortality rates declined for both isolated SAVR and TAVR, it became similar or slightly lower for TAVR than for isolated SAVR in 2015 in the 3 oldest age categories even if it did not reach statistical significance (p = 0.66, p = 0.47, and p = 0.06, respectively).
The number of AVRs markedly increased in France between 2007 and 2015 due to the wide adoption of TAVR, which represented one-third of all AVRs in 2015. Patients' profile improved, suggesting that patients are referred earlier, and in-hospital mortality declined in all AVR subsets. Despite a worse clinical profile, the immediate outcome of TAVR compared favorably to isolated SAVR in patients >75 years of age. The results may have major implications for clinical practice and policymakers. |
|---|---|
| AbstractList | Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR), but unbiased data regarding evolution of the treatment of patients with aortic stenosis at the nationwide level are scarce.BACKGROUNDTranscatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR), but unbiased data regarding evolution of the treatment of patients with aortic stenosis at the nationwide level are scarce.This study sought to evaluate the number of aortic valve replacements (AVRs) performed in France, changes over time, and the effect of the adoption of TAVR.OBJECTIVESThis study sought to evaluate the number of aortic valve replacements (AVRs) performed in France, changes over time, and the effect of the adoption of TAVR.Based on a French administrative hospital-discharge database, the study collected all consecutive AVRs performed in France between 2007 and 2015.METHODSBased on a French administrative hospital-discharge database, the study collected all consecutive AVRs performed in France between 2007 and 2015.A total of 131,251 interventions were performed: 109,317 (83%) SAVR and 21,934 (17%) TAVR. AVR linearly increased (from 10,892 to 18,704; p for trend <0.0001) mainly due to a marked increase in TAVR (from 244 to 6,722; p for trend = 0.0004), whereas SAVR remained stable (from 10,892 to 11,982; p for trend = 0.18). Parallel to a decrease in the Charlson index (p for trend <0.05), SAVR and TAVR in-hospital mortality rates significantly declined (both p for trend <0.01). The number of TAVRs significantly increased in all age categories (<75, 75 to 79, 80 to 84, and ≥85 years of age; all p for trend = 0.003), but reached or even exceeded SAVR in the 2 oldest categories. Although mortality rates declined for both isolated SAVR and TAVR, it became similar or slightly lower for TAVR than for isolated SAVR in 2015 in the 3 oldest age categories even if it did not reach statistical significance (p = 0.66, p = 0.47, and p = 0.06, respectively).RESULTSA total of 131,251 interventions were performed: 109,317 (83%) SAVR and 21,934 (17%) TAVR. AVR linearly increased (from 10,892 to 18,704; p for trend <0.0001) mainly due to a marked increase in TAVR (from 244 to 6,722; p for trend = 0.0004), whereas SAVR remained stable (from 10,892 to 11,982; p for trend = 0.18). Parallel to a decrease in the Charlson index (p for trend <0.05), SAVR and TAVR in-hospital mortality rates significantly declined (both p for trend <0.01). The number of TAVRs significantly increased in all age categories (<75, 75 to 79, 80 to 84, and ≥85 years of age; all p for trend = 0.003), but reached or even exceeded SAVR in the 2 oldest categories. Although mortality rates declined for both isolated SAVR and TAVR, it became similar or slightly lower for TAVR than for isolated SAVR in 2015 in the 3 oldest age categories even if it did not reach statistical significance (p = 0.66, p = 0.47, and p = 0.06, respectively).The number of AVRs markedly increased in France between 2007 and 2015 due to the wide adoption of TAVR, which represented one-third of all AVRs in 2015. Patients' profile improved, suggesting that patients are referred earlier, and in-hospital mortality declined in all AVR subsets. Despite a worse clinical profile, the immediate outcome of TAVR compared favorably to isolated SAVR in patients >75 years of age. The results may have major implications for clinical practice and policymakers.CONCLUSIONSThe number of AVRs markedly increased in France between 2007 and 2015 due to the wide adoption of TAVR, which represented one-third of all AVRs in 2015. Patients' profile improved, suggesting that patients are referred earlier, and in-hospital mortality declined in all AVR subsets. Despite a worse clinical profile, the immediate outcome of TAVR compared favorably to isolated SAVR in patients >75 years of age. The results may have major implications for clinical practice and policymakers. Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR), but unbiased data regarding evolution of the treatment of patients with aortic stenosis at the nationwide level are scarce. This study sought to evaluate the number of aortic valve replacements (AVRs) performed in France, changes over time, and the effect of the adoption of TAVR. Based on a French administrative hospital-discharge database, the study collected all consecutive AVRs performed in France between 2007 and 2015. A total of 131,251 interventions were performed: 109,317 (83%) SAVR and 21,934 (17%) TAVR. AVR linearly increased (from 10,892 to 18,704; p for trend <0.0001) mainly due to a marked increase in TAVR (from 244 to 6,722; p for trend = 0.0004), whereas SAVR remained stable (from 10,892 to 11,982; p for trend = 0.18). Parallel to a decrease in the Charlson index (p for trend <0.05), SAVR and TAVR in-hospital mortality rates significantly declined (both p for trend <0.01). The number of TAVRs significantly increased in all age categories (<75, 75 to 79, 80 to 84, and ≥85 years of age; all p for trend = 0.003), but reached or even exceeded SAVR in the 2 oldest categories. Although mortality rates declined for both isolated SAVR and TAVR, it became similar or slightly lower for TAVR than for isolated SAVR in 2015 in the 3 oldest age categories even if it did not reach statistical significance (p = 0.66, p = 0.47, and p = 0.06, respectively). The number of AVRs markedly increased in France between 2007 and 2015 due to the wide adoption of TAVR, which represented one-third of all AVRs in 2015. Patients' profile improved, suggesting that patients are referred earlier, and in-hospital mortality declined in all AVR subsets. Despite a worse clinical profile, the immediate outcome of TAVR compared favorably to isolated SAVR in patients >75 years of age. The results may have major implications for clinical practice and policymakers. |
| Author | Dindorf, Christel Eltchaninoff, Helene Gilard, Martine Chevreul, Karine Vahanian, Alec Michel, Morgane Messika-Zeitoun, David Nguyen, Virginia Mossialos, Elias Iung, Bernard Cribier, Alain |
| Author_xml | – sequence: 1 givenname: Virginia surname: Nguyen fullname: Nguyen, Virginia organization: Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France; INSERM U1148, Bichat Hospital, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France – sequence: 2 givenname: Morgane surname: Michel fullname: Michel, Morgane organization: Université Paris Diderot, Sorbonne Paris Cité, Paris, France; URC Eco Ile de France, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France; INSERM, ECEVE, U1123, Paris, France – sequence: 3 givenname: Helene surname: Eltchaninoff fullname: Eltchaninoff, Helene organization: Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France – sequence: 4 givenname: Martine surname: Gilard fullname: Gilard, Martine organization: Department of Cardiology, Brest University Hospital, Brest, France – sequence: 5 givenname: Christel surname: Dindorf fullname: Dindorf, Christel organization: Université Paris Diderot, Sorbonne Paris Cité, Paris, France; URC Eco Ile de France, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France; INSERM, ECEVE, U1123, Paris, France – sequence: 6 givenname: Bernard surname: Iung fullname: Iung, Bernard organization: Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France; INSERM U1148, Bichat Hospital, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France – sequence: 7 givenname: Elias surname: Mossialos fullname: Mossialos, Elias organization: LSE Health, London School of Economics & Political Science, London, United Kingdom – sequence: 8 givenname: Alain surname: Cribier fullname: Cribier, Alain organization: Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France – sequence: 9 givenname: Alec surname: Vahanian fullname: Vahanian, Alec organization: Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France; INSERM U1148, Bichat Hospital, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France – sequence: 10 givenname: Karine surname: Chevreul fullname: Chevreul, Karine organization: Université Paris Diderot, Sorbonne Paris Cité, Paris, France; URC Eco Ile de France, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France; INSERM, ECEVE, U1123, Paris, France – sequence: 11 givenname: David surname: Messika-Zeitoun fullname: Messika-Zeitoun, David email: DMessika-zeitoun@ottawaheart.ca organization: Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France; INSERM U1148, Bichat Hospital, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France. Electronic address: DMessika-zeitoun@ottawaheart.ca |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29650117$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNz19LwzAUBfAgE_dHv4APkkdfWnOTpWke53A6GAgyfS1peoMdbVqbVPDbO3SCT_cc-HHgzsnEdx4JuQaWAoPs7pAejLUpZ5CnDFKm9BmZgZR5IqRWk395SuYhHBhjWQ76gky5ziQDUDNyv237Blv00cS687RzdD8YH6yJ7xhxoKtuiLWlb6b5RPqCfWPsD6e1p5ujtHhJzp1pAl6d7oK8bh7266dk9_y4Xa92iZUyi4kRkgunKyYVosalUpqXjgsDZaWrpYaMSYGlrTJdCnDMaSXUsZZCOGtMzhfk9ne3H7qPEUMs2jpYbBrjsRtDwRmXAgRoeaQ3JzqWLVZFP9StGb6Kv7_5NwwiXP0 |
| CitedBy_id | crossref_primary_10_1053_j_semnuclmed_2020_02_005 crossref_primary_10_1159_000509389 crossref_primary_10_1093_eurheartj_ehaa643 crossref_primary_10_1016_j_jacc_2018_04_077 crossref_primary_10_1097_MAT_0000000000001864 crossref_primary_10_1056_NEJMoa1910555 crossref_primary_10_1093_eurheartj_ehab773 crossref_primary_10_1016_j_jacc_2018_02_025 crossref_primary_10_1161_JAHA_118_011504 crossref_primary_10_1136_heartjnl_2022_321594 crossref_primary_10_1161_HYPERTENSIONAHA_123_21226 crossref_primary_10_1161_JAHA_120_016086 crossref_primary_10_1016_j_jaccao_2019_10_004 crossref_primary_10_1016_j_acvd_2019_03_004 crossref_primary_10_1016_j_ijcard_2019_06_061 crossref_primary_10_1016_j_amjcard_2020_05_043 crossref_primary_10_1016_j_acvd_2024_02_007 crossref_primary_10_1136_openhrt_2020_001345 crossref_primary_10_1007_s00392_020_01615_y crossref_primary_10_1016_j_compbiomed_2024_108552 crossref_primary_10_1007_s11886_019_1108_x crossref_primary_10_1080_24748706_2019_1630787 crossref_primary_10_1002_ccd_28361 crossref_primary_10_1016_j_jtcvs_2020_02_078 crossref_primary_10_1093_ejcts_ezz316 crossref_primary_10_1016_j_cmi_2020_01_036 crossref_primary_10_2215_CJN_14721219 crossref_primary_10_1016_j_cjca_2024_03_007 crossref_primary_10_1016_j_athoracsur_2021_06_067 crossref_primary_10_1016_j_jacasi_2025_01_017 crossref_primary_10_1093_ehjqcco_qcad018 crossref_primary_10_1136_heartjnl_2022_321566 crossref_primary_10_1371_journal_pone_0227345 crossref_primary_10_1093_ejcts_ezaa144 crossref_primary_10_1093_ndt_gfac153 crossref_primary_10_1016_j_carrev_2020_05_016 crossref_primary_10_1016_j_jcin_2024_10_038 crossref_primary_10_1016_j_jacc_2021_09_864 crossref_primary_10_1016_j_acvd_2019_09_008 crossref_primary_10_1161_CIRCULATIONAHA_119_043971 crossref_primary_10_1016_j_annepidem_2025_01_005 crossref_primary_10_1093_ejcts_ezz126 crossref_primary_10_1016_j_amjcard_2023_08_088 crossref_primary_10_1161_JAHA_120_015896 crossref_primary_10_1016_j_compbiomed_2024_108526 crossref_primary_10_1093_ehjqcco_qcaf061 crossref_primary_10_1093_ehjqcco_qcae012 crossref_primary_10_1136_heartjnl_2019_316058 crossref_primary_10_1161_JAHA_118_011206 crossref_primary_10_1161_JAHA_120_021748 crossref_primary_10_3390_jcm9123963 crossref_primary_10_1080_24748706_2018_1556829 crossref_primary_10_1016_j_ijcard_2021_05_039 crossref_primary_10_1080_00015385_2023_2282283 crossref_primary_10_1111_jocs_16053 crossref_primary_10_1016_j_jacc_2020_02_051 crossref_primary_10_1093_eurheartj_ehad121 crossref_primary_10_1161_JAHA_118_011833 crossref_primary_10_1093_ejcts_ezab135 crossref_primary_10_1016_j_hrthm_2021_06_1175 crossref_primary_10_1007_s00392_020_01609_w crossref_primary_10_1093_ejcts_ezae122 |
| ContentType | Journal Article |
| Copyright | Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
| Copyright_xml | – notice: Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
| DBID | NPM 7X8 |
| DOI | 10.1016/j.jacc.2018.01.079 |
| DatabaseName | PubMed MEDLINE - Academic |
| DatabaseTitle | PubMed MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic PubMed |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1558-3597 |
| ExternalDocumentID | 29650117 |
| Genre | Research Support, Non-U.S. Gov't Journal Article |
| GroupedDBID | --- --K --M .1- .FO .~1 0R~ 18M 1B1 1P~ 1~. 1~5 2WC 4.4 457 4G. 53G 5GY 5RE 5VS 6PF 7-5 71M 8P~ AABNK AABVL AACTN AAEDT AAEDW AAIKJ AAKUH AALRI AAOAW AAQFI AAQQT AAXUO ABBQC ABFNM ABFRF ABLJU ABMAC ABMZM ABOCM ACGFO ACGFS ACIUM ACJTP ACPRK ADBBV ADEZE ADVLN AEFWE AEKER AENEX AEVXI AEXQZ AFCTW AFETI AFRAH AFRHN AFTJW AGYEJ AHMBA AITUG AJRQY AKRWK ALMA_UNASSIGNED_HOLDINGS AMRAJ BAWUL BLXMC CS3 DIK DU5 E3Z EBS EJD EO8 EO9 EP2 EP3 F5P FDB FEDTE FNPLU G-Q GBLVA GX1 H13 HVGLF IHE IXB J1W K-O KQ8 L7B MO0 N9A NPM O-L O9- OA. OAUVE OK1 OL~ OZT P-8 P-9 P2P PC. PQQKQ Q38 RIG ROL RPZ SCC SDF SDG SDP SES SSZ TR2 UNMZH UV1 W8F WH7 WOQ WOW YYM YZZ Z5R 7X8 ACVFH ADCNI AEUPX AFPUW AIGII AKBMS AKYEP EFKBS EFLBG ~HD |
| ID | FETCH-LOGICAL-c556t-a3523f9d057ee9e47792bf23a1bd9d4916053ebcd69b31f0f9737bcdb33fcaa82 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 74 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000429534100003&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1558-3597 |
| IngestDate | Sun Sep 28 11:28:02 EDT 2025 Thu Apr 03 06:58:07 EDT 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 15 |
| Keywords | transcatheter therapies aortic stenosis aortic valve replacement outcome |
| Language | English |
| License | Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c556t-a3523f9d057ee9e47792bf23a1bd9d4916053ebcd69b31f0f9737bcdb33fcaa82 |
| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
| OpenAccessLink | https://www.clinicalkey.com/#!/content/1-s2.0-S0735109718332571 |
| PMID | 29650117 |
| PQID | 2025313195 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2025313195 pubmed_primary_29650117 |
| PublicationCentury | 2000 |
| PublicationDate | 2018-04-17 |
| PublicationDateYYYYMMDD | 2018-04-17 |
| PublicationDate_xml | – month: 04 year: 2018 text: 2018-04-17 day: 17 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Journal of the American College of Cardiology |
| PublicationTitleAlternate | J Am Coll Cardiol |
| PublicationYear | 2018 |
| References | 29650118 - J Am Coll Cardiol. 2018 Apr 17;71(15):1628-1630 |
| References_xml | – reference: 29650118 - J Am Coll Cardiol. 2018 Apr 17;71(15):1628-1630 |
| SSID | ssj0006819 |
| Score | 2.520826 |
| Snippet | Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR), but unbiased data regarding evolution... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 1614 |
| Title | Implementation of Transcatheter Aortic Valve Replacement in France |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/29650117 https://www.proquest.com/docview/2025313195 |
| Volume | 71 |
| WOSCitedRecordID | wos000429534100003&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3NS8MwFA_qRLz4_TG_iOC1sDZp05xkisODGzvo2K2kyQtMXDvd3N_vS5qxmwheCqUJLa-_5P3yXvJ7hNxlINFJMhYJ4DriWvNICUAsp4DLnoQx7RX4Ri9iMMjHYzkMAbd52Fa5mhP9RG1q7WLkbpGOcEHApPezz8hVjXLZ1VBCY5O08Jl0W7rEeK0WnuW-sAe6zBxfLkU4NNPs73pX2kkYxrmX7RS_UEzvanr7__3IA7IXSCbtNqg4JBtQHZGdfkijH5MHrwk8DceOKlpb6n2W13BFQ9Nu7brSkfpYAkWO7mLtrjmdVNSX4oAT8tZ7en18jkIxhUinabaIFDItZqVBfgYggQshk9ImTMWlkYYjS8ThCKU2mSxZbDtWCibwtmTMaqXy5JRsVXUF54R2UqfSbkyqwPDYIsPJNM-xbZKWkgO0ye3KOgWC1WUgVAX197xY26dNzhoTF7NGVaNIJJLFOBYXf-h9SXbdn3NZnVhckZbFoQrXZFsvF5P5141HAV4Hw_4PV3G7oQ |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Implementation+of+Transcatheter+Aortic+Valve+Replacement+in+France&rft.jtitle=Journal+of+the+American+College+of+Cardiology&rft.au=Nguyen%2C+Virginia&rft.au=Michel%2C+Morgane&rft.au=Eltchaninoff%2C+Helene&rft.au=Gilard%2C+Martine&rft.date=2018-04-17&rft.issn=1558-3597&rft.eissn=1558-3597&rft.volume=71&rft.issue=15&rft.spage=1614&rft_id=info:doi/10.1016%2Fj.jacc.2018.01.079&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1558-3597&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1558-3597&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1558-3597&client=summon |