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{\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/13\\\/23\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/13\\\/23\u0022}],\u0022ac\u0022:{\u0022spmdc;14\\\/13\\\/23\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;14\\\/13\\\/23\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ELower extremity arterial diseases can cause substantial morbidity. Recent improvements in interventional technologies have resulted in improved outcomes.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ethrombotic disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einterventional techniques \u0026amp; devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ethromboembolic disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecoronary artery disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003ELower extremity arterial diseases can cause substantial morbidity. Recent improvements in interventional technologies have resulted in improved outcomes. Michael J. Rinaldi, MD, Sanger Heart and Vascular Institute, Charlotte, North Carolina, USA, discussed medical therapy for claudication. Lower extremity claudication can be caused by not only atherosclerosis but also venous claudication, cystic adventitial disease, popliteal entrapment syndrome, iliac fibromuscular dysplasia, and iliac artery fibrosis. In most cases, surgery or stenting is indicated. However, medical therapy can improve survival, although it may not alter the symptoms of claudication. Class I recommendations for medical therapy include smoking cessation, statin therapy, antiplatelet therapy, management of hypertension, and control of diabetes. In addition, an exercise program can improve symptoms of claudication. Dr. Rinaldi stated that 4 to 6 weeks of a walking program is long enough to elicit improvements in patients who will benefit from an exercise program. The addition of cilostazol to a walking exercise program can also increase walking distances and improve quality of life, although side effects of the drug may limit its use.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EJ. Michael Bacharach, MD, MPH, North Central Heart Institute, Sioux Falls, South Dakota, USA, examined the role of anatomy in determining when to intervene in patients with peripheral artery disease (PAD). In general, intervention is most likely indicated when medical therapy does not resolve lifestyle-limiting claudication and if the patient experiences rest pain, nonhealing ulcers, or gangrene. In determining the best intervention, the patient\u0027s PAD should be differentiated as aortoiliac disease or infrainguinal disease. For aortoiliac disease, endovascular therapy or surgical revascularization may be indicated, whereas infrainguinal disease may require provisional stenting, surgical revascularization, or referral to a pharmacotherapy clinical trial. Depending on the underlying disease etiology, endovascular procedures have varying success rates, with the highest for infrainguinal disease, femoropopliteal disease, and aortoiliac occlusive disease; however, in many cases, long-term durability may be questionable, and restenosis or reocclusion can occur. Dr. Bacharach expressed his interest in new technologies that may improve outcomes in stenting of PAD.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EEhrin J. Armstrong, MD, MSc, VA Eastern Colorado Healthcare System, Denver, Colorado, USA, discussed the association of the stent type used in iliac intervention and outcomes. Balloon-expandable stents are best used for disease with bifurcations, calcified lesions, or disease located in the common iliac, whereas a self-expanding stent should be used for tortuous vessels, long lesions, or disease located in the distal external iliac. The MELODIE trial [Stockx L et al. \u003Cem\u003EJ Endovasc Ther\u003C\/em\u003E 2010], MOBILITY OE trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01396525\u0026amp;atom=%2Fspmdc%2F14%2F13%2F23.atom\u0022\u003ENCT01396525\u003C\/a\u003E], and ACTIVE trial [Molnar RG et al. \u003Cem\u003EJ Endovasc Ther\u003C\/em\u003E 2013] showed that balloon-expandable iliac stents provide excellent outcomes in patients with straightforward lesions, with primary patency rates ranging from 89.1% to 99.2% for up to 12 months of follow-up (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). Similarly, self-expanding stents demonstrated primary patency rates of \u2265 90% in the CRISP-US trial [Ponec D et al. \u003Cem\u003EJ Vasc Interv Radiol\u003C\/em\u003E 2004], Zilver trial [Krol KL et al. \u003Cem\u003EJ Vasc Interv Radiol\u003C\/em\u003E 2008], and MOBILITY AP trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00844532\u0026amp;atom=%2Fspmdc%2F14%2F13%2F23.atom\u0022\u003ENCT00844532\u003C\/a\u003E].\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16413\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16413\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16413\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EOutcomes of Varying Stent Types by Trial\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EGary M. Ansel, MD, Ohio Health\/Riverside Methodist Hospital, Columbus, Ohio, USA, discussed treating the femoral and popliteal arteries. Initial stent technologies for femoral or popliteal artery diseases had patencies ranging from 28% to 53% [Rocha-Singh KJ et al. \u003Cem\u003ECatheter Cardiovasc Interv\u003C\/em\u003E 2007]; however, new technologies have improved these rates. For example, the use of bare-metal stents (BMSs) increased the primary patency rate in noncomplex lesions from 38% with percutaneous transluminal angioplasty (PTA) to 80% with PTA plus LifeStent (p \u0026lt; .0001) [Laird JR et al. \u003Cem\u003ECirc Cardiovasc Interv\u003C\/em\u003E 2010]. The STROLL trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00739102\u0026amp;atom=%2Fspmdc%2F14%2F13%2F23.atom\u0022\u003ENCT00739102\u003C\/a\u003E] had a primary patency rate of 74.9% with a BMS at 2 years [Jaff MR et al. \u003Cem\u003EEndovasc Ther\u003C\/em\u003E 2014]. The DURABILITY II trial showed that at 3 years, the loss of primary patency was 60% [Matsumura JS et al. \u003Cem\u003EJ Vasc Surg\u003C\/em\u003E 2013]. However, in complex superficial femoral artery (SFA) disease, primary-assisted patency rates were 88% at 3 years, compared with a rate of 69.8% for a polytetrafluoroethylene-lined stent [Geraghty PJ et al. \u003Cem\u003EJ Vasc Surg\u003C\/em\u003E 2013]. In addition, the use of a nonheparin-bonded stent graft did not significantly increase 1-, 2-, or 4-year patency rates compared with a BMS [McQuade K et al. \u003Cem\u003EJ Vasc Surg\u003C\/em\u003E 2010; Kedora J et al. \u003Cem\u003EJ Vasc Surg\u003C\/em\u003E 2007]. However, in terms of freedom from loss of primary patency, a heparin-coated contoured-edge stent graft had a rate of 74% at 12 months in the VIPER registry [Saxon RR et al. \u003Cem\u003EJ Vasc Interv Radiol\u003C\/em\u003E 2013]. The VIPER registry also indicated that sizing of the stent was important; the rate of freedom from loss of patency was 88% in stents that were \u2264 20% oversized, compared with 70% that were \u0026gt; 20% oversized (p \u0026lt; .05). Furthermore, a randomized controlled trial showed that the Viabahn heparin-coated contoured-edge stent resulted in significant improvements in freedom from loss of patency compared with a BMS (p \u0026lt; .01) [\u003Ca href=\u0022\/external-ref?link_type=ISRCTN\u0026amp;access_num=ISRCTN48164244\u0022 class=\u0022external-ref external-ref-type-isrctn\u0022\u003EISRCTN48164244\u003C\/a\u003E]. Drug-eluting stents (DESs) have also shown an improvement in primary patency over PTA at 12 months (p \u0026lt; .01), as well as BMSs at 24 months (p = .05) [Dake MD et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2013].\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003ELawrence A. Garcia, MD, Tufts University School of Medicine, Boston, Massachusetts, USA, discussed lower extremity revascularization and specifically the role of debulking therapies in the current endovascular landscape. Although endovascular therapy has become the primary approach for the treatment of lower extremity diseases, debulking therapies have had a resurgence for a myriad of reasons. Dr. Garcia reviewed the data from laser, directional, and rotational devices. Directional atherectomy is an alternative that is safe and effective. The DEFINITIVE LE trial [NCT0083246] showed that directional atherectomy achieved primary patency rates of up to 78% in patients with lesion lengths up to 20 cm and an overall primary patency rate of 76% in calcified lesions at 12 months across multiple anatomic beds. Specifically, for the SFA, the patency rates in the \u2264 10-cm lesions were 83%. Periprocedural complications included distal embolization (3.8%), flow-limiting dissection (2.3%), and perforation (5.3%). However, for calcific lesions, aggressive rotational or directional devices are indicated. Rotational atherectomy for infrapopliteal revascularization showed improvement by the Rutherford-Becker scale in 78% of patients with critical limb ischemia (CLI) at 6 months [Safian RD et al. \u003Cem\u003ECatheter Cardiovasc Interv\u003C\/em\u003E 2009]. The data set for rotational devices is growing with the future of LIBERTY 360 on the horizon, which will shed some light on orbital atherectomy and its use for both the claudicant and CLI patient. The potential for any debulking therapy to be used in conjunction with drug-coated balloon technology seems attractive though, to date, still untested. The DEFINITIVE AR study has a completed enrollment for this purpose and will be presented in 2015.\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EA presentation from Carlos Mena, MD, Yale University School of Medicine, New Haven, Connecticut, USA, discussed the treatment of CLI. The DEBATE-BTK trial randomly assigned patients with CLI and diabetes to undergo stenting with a drug-coated balloon (DCB) or standard PTA [Liistro F et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2013]. At 1 year, treatment with DCB significantly improved binary restenosis, target lesion revascularization (TLR), and complete ulcer healing, compared with PTA (p \u2264 .01); advantages were generally maintained at 2 years (Liistro F, LINC 2014; \u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16414\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16414\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16414\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-11\u0022 class=\u0022first-child\u0022\u003E2-Year Outcomes of Drug-Coating Balloon Therapy in Critical Limb Ischemia, % (n)\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EHowever, researchers of the IN.PACT DEEP trial found that drug-eluting balloon treatment had no effect on clinically driven TLR at 12 months but was noninferior to PTA for 6-month death, major amputation, or clinically driven TLR (p = .021) [Zeller T et al. \u003Cem\u003ELINC\u003C\/em\u003E 2014]. DES therapy in 3 trials improved TLR rates compared with BMSs or PTA [Bosiers M et al. \u003Cem\u003EJ Cardiovasc Surg (Torino)\u003C\/em\u003E 2011; Rastan A et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2011; Scheinert D et al. \u003Cem\u003EJACC Cardiovasc Interv\u003C\/em\u003E 2012]. In addition, the primary patency rates were significantly improved, from \u223c 56% with BMSs or PTA to \u223c 82% with DESs. The YUKON-BTK trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00664963\u0026amp;atom=%2Fspmdc%2F14%2F13%2F23.atom\u0022\u003ENCT00664963\u003C\/a\u003E] showed that treatment with DESs resulted in significantly greater event-free survival compared with BMSs at 24 months (p = .02), as well as significantly fewer major or minor amputations (p = .04).\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EDmitriy N. Feldman, MD, Weill Cornell Medical College, New York, New York, USA, described management of patients following peripheral intervention. Potential complications after intervention include bleeding, pseudoaneurysm, and arteriovenous fistula formation, as well as thrombosis, infection, and neuropathy. To reduce postprocedural complications or their effects, clinicians should ensure that they are readily available after the procedure, consider routine access site angiography, pay close attention to the final angiography using multiple orthogonal views, and be prepared to handle complications in terms of availability of equipment and staff education. After hospital discharge, follow-up after revascularization should include a long-term surveillance program with Doppler ultrasound at baseline and every 12 months after the first year to evaluate for patency [Mohler ER et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2012]. A meta-analysis of 22 trials with \u2265 3500 patients revealed no benefit for any single or combination therapy to prevent reocclusion; however, cilostazol treatment did result in a lower rate of reocclusion compared with ticlopidine (p = .01) and low-molecular-weight heparin plus aspirin decreased occlusion and restenosis in patients with CLI (p = .0003) [Robertson L et al. \u003Cem\u003ECochrane Database Syst Rev\u003C\/em\u003E 2012].\u003C\/p\u003E\n         \u003Cp id=\u0022p-15\u0022\u003ETreatment of lower extremity arterial diseases has improved with newer technologies, including the use of BMSs and DESs. Although reocclusion remains a challenge, new technologies and techniques have increased success rates and improved reocclusion rates.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/13\/23.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzoz81\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzoz81\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}