{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:19:46Z","timestamp":1790813986810,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["NS\/A000027\/1"],"award-info":[{"award-number":["NS\/A000027\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004040","name":"KU Leuven","doi-asserted-by":"publisher","award":["Post\u2010Doctoral Mandate 18\/215"],"award-info":[{"award-number":["Post\u2010Doctoral Mandate 18\/215"]}],"id":[{"id":"10.13039\/501100004040","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the efficacy and safety of the \u2018smart\u2019 tracheal occlusion (Smart\u2010TO) device in fetal lambs with diaphragmatic hernia (DH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DH was created in fetal lambs on gestational day\u200970 (term, 145\u2009days). Fetuses were allocated to either pregnancy continuation until term (DH group) or fetoscopic endoluminal tracheal occlusion (TO), performed using the Smart\u2010TO balloon on gestational day\u200997 (DH\u2009+\u2009TO group). On gestational day\u2009116, the presence of the balloon was confirmed on ultrasound, then the ewe was walked around a 3.0\u2010Tesla magnetic resonance scanner for balloon deflation, which was confirmed by ultrasound immediately afterwards. At term, euthanasia was performed and the fetus retrieved. Efficacy of occlusion was assessed by the lung\u2010to\u2010body\u2010weight ratio (LBWR) and lung morphometry. Safety parameters included tracheal side effects assessed by morphometry and balloon location after deflation. The unoccluded DH lambs served as a comparator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six fetuses were included in the DH group and seven in the DH\u2009+\u2009TO group. All balloons deflated successfully and were expelled spontaneously from the airways. In the DH\u2009+\u2009TO group, in comparison to controls, the LBWR at birth was significantly higher (1.90 (interquartile range (IQR), 1.43\u20132.55)\n                      <jats:italic>vs<\/jats:italic>\n                      1.07 (IQR, 0.93\u20131.46);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005), while on lung morphometry, the alveolar size was significantly increased (mean linear intercept, 47.5 (IQR, 45.6\u201348.1)\n                      <jats:italic>vs<\/jats:italic>\n                      41.9 (IQR, 38.8\u201346.1)\n                      <jats:italic>\u03bc<\/jats:italic>\n                      m;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03); whereas airway complexity was lower (mean terminal bronchiolar density, 1.56 (IQR, 1.0\u20131.81)\n                      <jats:italic>vs<\/jats:italic>\n                      2.23 (IQR, 2.14\u20132.40) br\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005). Tracheal changes on histology were minimal in both groups, but more noticeable in fetal lambs that underwent TO than in unoccluded lambs (tracheal score, 2 (IQR, 1\u20133)\n                      <jats:italic>vs<\/jats:italic>\n                      0 (0\u20131);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In fetal lambs with DH, TO using the Smart\u2010TO balloon is effective and safe. Occlusion can be reversed non\u2010invasively and the deflated intact  balloon expelled spontaneously from the fetal upper airways. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.23135","type":"journal-article","created":{"date-parts":[[2020,10,4]],"date-time":"2020-10-04T01:26:45Z","timestamp":1601774805000},"page":"105-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Safety and efficacy of smart tracheal occlusion device in diaphragmatic hernia lamb model"],"prefix":"10.1002","volume":"57","author":[{"given":"D.","family":"Basurto","sequence":"first","affiliation":[{"name":"Academic Department of Development and Regeneration Cluster Woman and Child, Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Sanan\u00e8s","sequence":"additional","affiliation":[{"name":"INSERM 1121 Biomaterials and Bioengineering Strasbourg University  Strasbourg France"},{"name":"Department of Maternal\u2013Fetal Medicine Strasbourg University Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bleeser","sequence":"additional","affiliation":[{"name":"Academic Department of Development and Regeneration Cluster Woman and Child, Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Valenzuela","sequence":"additional","affiliation":[{"name":"Academic Department of Development and Regeneration Cluster Woman and Child, Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"De Leon","sequence":"additional","affiliation":[{"name":"Academic Department of Development and Regeneration Cluster Woman and Child, Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Joyeux","sequence":"additional","affiliation":[{"name":"Academic Department of Development and Regeneration Cluster Woman and Child, Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Verbeken","sequence":"additional","affiliation":[{"name":"Department of Pathology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Vergote","sequence":"additional","affiliation":[{"name":"Academic Department of Development and Regeneration Cluster Woman and Child, Biomedical Sciences, KU Leuven  Leuven Belgium"},{"name":"Clinical Department of Obstetrics and Gynaecology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Van der Veeken","sequence":"additional","affiliation":[{"name":"Academic Department of Development and Regeneration Cluster Woman and Child, Biomedical Sciences, KU Leuven  Leuven Belgium"},{"name":"Clinical Department of Obstetrics and Gynaecology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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