{"id":129391,"date":"2021-12-20T00:00:00","date_gmt":"2021-12-20T00:00:00","guid":{"rendered":"https:\/\/nursingstudybay.com\/2021\/12\/20\/radial-artery-access-to-bronchial-artery-embolization\/"},"modified":"2021-12-20T00:00:00","modified_gmt":"2021-12-20T00:00:00","slug":"radial-artery-access-to-bronchial-artery-embolization","status":"publish","type":"post","link":"https:\/\/www.studyproessays.com\/help\/radial-artery-access-to-bronchial-artery-embolization\/","title":{"rendered":"Radial Artery Access to Bronchial Artery Embolization"},"content":{"rendered":"

Study Bay Coursework Assignment Writing Help<\/p>\n

<\/a>Radial artery<\/strong> access to<\/strong> <\/a>b<\/strong>ronchial<\/strong> artery embolization for massive hemoptysis: a case<\/strong> report<\/strong><\/p>\n

Abstract<\/strong><\/p>\n

Background:<\/strong><\/del> <\/del>Massive hemoptysis is a potentially fatal respiratory emergency. Bronchial artery embolization (BAE) is commonly applied to treat massive hemoptysis. However, in most cases, BAE was performed via the access of femoral artery. The treatment via the access of radial artery is rare and challenging. <\/ins><\/p>\n

Case<\/strong><\/del> d<\/strong><\/del>escription:<\/strong><\/del> <\/del>Herein<\/strong><\/ins> <\/ins><\/a>We<\/del> w<\/ins>e<\/ins> reported<\/del> a case of massive hemoptysis (woman aged 63 years). We discussed<\/del> the results and treatment of the patient, and reviewed<\/del> the literature. The patient was treated successfully with BAE via the access of radial artery using polyvinyl alcohol particles. Right intercostal artery, right bronchial artery, right subclavian arterial branch, right internal thoracic artery and right thyrocervical trunk<\/ins> <\/ins>w<\/ins>as<\/ins><\/del>ere<\/ins> embolized.<\/ins> <\/ins>Hemoptysis was controlled. The patient was followed up since surgery, and there was a recurrence of bleeding at 6 months following embolization. Up to now, no hemoptysis or other complications occurred.[f1]<\/a><\/p>\n

Conclusion:<\/strong><\/del> <\/del>Radial artery access to BAE is effective for the treatment of massive hemoptysis. <\/a>Nevertheless, few cases have been reported.<\/del> More<\/del> clinical and experimental<\/del> research<\/del>es<\/del> are needed to confirm the safety and effectiveness in the treatment of hemoptysis.<\/del>[f2]<\/a><\/p>\n

Keywords:<\/strong> radial artery; bronchial artery embolization; massive hemoptysis<\/p>\n

I<\/strong>ntroduction<\/strong><\/p>\n

<\/del><\/a> <\/del><\/a>Hemoptysis[f3]<\/a> is a general clinical manifestation characterized by<\/ins> <\/ins>considered<\/del> as the<\/del> expectoration of blood that<\/del> derive<\/del>s<\/del> from the lower respiratory tract [1<\/a>]. There are m<\/del>M<\/ins>any etiologies<\/ins> <\/ins>causes<\/del> contribute<\/ins> <\/ins>to h<\/ins>emoptysis<\/ins>,<\/ins> <\/ins>leading to h<\/del>emoptysis<\/del> <\/del>such as<\/del> including tuberculosis, bronchiectasis and lung cancer [2<\/a>, 3<\/a>]. In most cases, the hemoptysis is moderate and resolved wit<\/a>h conservative medical<\/ins> therapy. [f4]<\/a>However, for<\/ins> m<\/ins>assive hemoptysis<\/ins> patients that are defined as<\/ins> more than 300 mL of expectorated blood in a period of 24 hours <\/ins> <\/del>is universally accepted<\/del> as the<\/del> d<\/del>efinition of massive hemoptysis<\/del> <\/del>in most<\/del> case<\/del>s<\/del> <\/del>[4<\/a>],<\/ins> C<\/del>c<\/ins>onservative medical or surgical<\/del> treatment for massive hemoptysis seemed to be<\/ins> are<\/del> ineffectual, <\/ins>the<\/ins> mortality<\/ins> rate is<\/ins> in 50% to<\/ins> <\/ins>100%<\/ins> [5<\/a>].<\/ins> While surgical tre<\/ins>atment of massive hemoptysis is<\/ins> <\/ins>related<\/ins>ed with mortality rates of 7.1<\/ins>\u2013<\/ins>18.2%,<\/ins> t<\/a>he mortality rate of<\/del> massive hemoptysi<\/del>[f5]<\/a>s<\/del> is up to 40% when surgery is performed urgently [6<\/a>].. <\/ins><\/a> <\/del><\/a>M<\/del>assive hemoptysis is a life-threatening<\/del> respiratory emergency<\/del> that needs urgent treatment<\/del> <\/del>.<\/del> <\/del>A former<\/del> stud<\/del>y<\/del> <\/del>has<\/del> report<\/del>ed<\/del> <\/del>the<\/del> mortality rate<\/del> was<\/del> up to 80<\/del>%<\/del> mainly due to asphyxiation<\/del> .<\/del>[f6]<\/a><\/p>\n

<\/del> Nowadays, there is no global consensus about the optimal treatment of patients with massive hemoptysis, and there are no considerable patients studied [7<\/a>]. Conservative medical or surgical treatment for massive hemoptysis are ineffectual, the mortality rate of massive hemoptysis is up to 40% when surgery is performed urgently [7<\/a>]. Complementarily, <\/a>bronchial artery embolization (BAE) is an optional method in the management of massive hemoptysis [8<\/a>].<\/p>\n

I<\/ins>t is routine to perform<\/ins> BAE<\/ins> <\/ins>via the access of<\/ins> femoral artery<\/ins> <\/ins>[9-11<\/a>].<\/ins> G<\/ins>enerally,<\/ins> bl<\/ins>eeding<\/ins> vessels<\/ins> can be found and<\/ins> emboliz<\/ins>e<\/ins>d<\/ins> successful<\/ins>ly<\/ins>.<\/ins> <\/ins>W<\/ins>hile<\/ins> catheter could not be inserted<\/ins> into the<\/ins> lesion vessels<\/ins> via<\/ins> conventional approach successful<\/ins>ly<\/ins>,<\/ins> we<\/ins> can try to change the direction of the catheter<\/ins>.<\/ins> <\/ins>T<\/ins>herefore<\/ins>, radial artery approach for<\/ins> BAE<\/ins> provides a new method<\/ins> <\/ins>to<\/ins> the treatment of intractable hemoptysis<\/ins>.<\/ins> <\/ins><\/a>However[7]<\/a>, t<\/ins>he treatment via the access of radial artery is rare and challenging.<\/ins><\/a>few have been reported<\/del>[8]<\/a> catheter was introduc<\/del>ed into the<\/del> <\/a>radial artery<\/del> using<\/del> <\/del>the Seldinger technique for the management of hemoptysis.<\/del> Here, we describe a case of massive hemoptysis caused by tuberculosis successfully treated with BAE via the access of radial artery.<\/p>\n

Case report<\/strong><\/p>\n

<\/del> <\/del>A 63-year-old woman was admitted to the emergency department of<\/ins> our<\/ins> hospital<\/ins> <\/ins> <\/del>d<\/ins>ue to<\/ins> intermittent hemoptysis<\/ins> for<\/ins> more than 6<\/ins> <\/ins>month<\/ins>s<\/ins>.<\/ins> <\/ins>T<\/ins>he<\/ins>with<\/del> massive<\/del> hemoptysis <\/ins>symptom<\/ins> was not resolved by<\/ins> after<\/del> n<\/del>o significant relief<\/del> with<\/del> medical treatment (anti-inflammatory as well as symptomatic and supportive care), but<\/ins> .<\/del> Hemoptysis<\/del> symptoms<\/del> became progressively severe 3 days before the accession to the emergency department with the<\/ins>a<\/del>nd the<\/del> about 500 mL<\/ins>total amount of<\/del> hemoptysis <\/ins>amount<\/ins> <\/del>was<\/del> about 500 mL<\/del>. Moreover, she had<\/del> complained of<\/del> <\/del>more than 6-month history of<\/del> intermittent hemoptysis<\/del>.<\/del> <\/del>She had a history of pulmonary tuberculosis prior.<\/p>\n

<\/ins> <\/del>C<\/ins>omputed tomography angiography<\/ins> CTA<\/del> (<\/a>CTA<\/ins>computed tomography angiography<\/del>) examination was refused by patient and their families, and the informed consent was signed after communication. After blood cell analysis, the biochemistry analysis, blood gas analysis and monitoring of vital signs, the patient was schedule<\/ins>d to undergo<\/ins>subjected to<\/del> BAE for hemostasis after communication with family members.<\/p>\n

A standardized BAE procedure was applied [9<\/a>, 12<\/a>]. A 5F cobra catheter (Glide, Terumo, Japan) was introduced into the right <\/a>femoral artery using the Seldinger technique. A flush catheter was advanced into the upper portion of the descending thoracic aorta to identify the bleeding arteries. The embolization was performed with poly<\/ins>vinyl alcohol<\/ins> <\/ins>PVA<\/del> (PVA<\/ins>poly<\/del>vinyl alcohol<\/del>) particles. Right intercostal artery (Figure 1 A), right bronchial artery (Figure 1 B), <\/a>right subclavian arterial branch (Figure 2<\/del>1<\/ins> A<\/del>C<\/ins>), <\/a>right internal thoracic artery (Figure 2<\/del>1<\/ins> B<\/del>D<\/ins>) and right thyrocervical trunk (Figure 3<\/del>1<\/ins> A<\/del>E<\/ins>) was<\/del> <\/a>were<\/ins> embolized.<\/a> However, <\/ins> <\/del>this<\/del> <\/del>approach<\/del> was ineffective<\/del> <\/del>when<\/del> <\/a>BAE<\/del> was<\/del> performed<\/del> <\/del>via the access to<\/del> femoral artery<\/del>.<\/del> [9]<\/a>Ang<\/del>iography<\/del> a<\/ins>ng<\/ins>iography<\/ins> displayed <\/a>a <\/a>lesion vessel along<\/del> with<\/del> <\/a>arteriovenous fistula<\/del> <\/del>at the proximal end and the vertebral artery side of the right subclavian artery <\/ins>along<\/ins> with arteriovenous fistula<\/ins> ([10]<\/a>Figure 3<\/del>1<\/ins> B<\/del>F<\/ins>). This approach was ineffective when BAE was performed via the access to femoral artery.<\/ins> <\/ins>After analysis,<\/ins> judge<\/ins><\/del> the<\/ins> direction<\/ins><\/del> <\/ins><\/del>ostium<\/ins> of blood vessel<\/ins>s<\/ins><\/del> <\/ins>open up and<\/ins><\/del> <\/ins><\/del>was<\/ins> <\/ins>upward<\/ins>.<\/ins> <\/ins>C<\/ins>onventional<\/ins> direction<\/ins> of<\/ins> catheter upward<\/ins> was<\/ins> not<\/ins> performed via<\/ins> superselective catheterization<\/ins> in<\/ins>to<\/ins> th<\/ins>e<\/ins> <\/ins>lesion artery<\/ins>.<\/ins> <\/a>Thus, we decided to change the direction of catheter for BAE.[11]<\/a> We tried to insert the 5F cobra catheter into the right radial artery to perform BAE (Figure 4<\/del>1<\/ins> A<\/del>G<\/ins>). The shape of 5F cobra catheter was changed to match the <\/a>lesion artery easily, following BAE performance (Figure 4<\/del>1<\/ins> B<\/del>H<\/ins>\u2013C<\/del>I<\/ins>). Angiography displayed that the lesion artery was completely <\/a>embolized, indicating a good outcome (Figure 4<\/del>1<\/ins> D<\/del>J<\/ins>).<\/p>\n

The patient was sent to his ward after BAE. Following the embolization, his vital signs were stable, and hemoptysis symptoms were alleviated significantly. So the patient was discharged at the fifth day after surgery. Hemoptysis occurred again at <\/del>a<\/del> follow-up<\/del> 6 months following the surgery, with<\/ins> the main clinical symptom <\/del>was<\/del> of<\/ins> less bloody sputum. The patient was treated with anti-inflammatory, hemostasis and symptomatic treatment at a local hospital. She was discharged after her condition was improved after 1 week. Up to now, no hemoptysis or other complications occurred.<\/p>\n

<\/a>Discussion<\/strong>[12]<\/a><\/p>\n

<\/del> <\/del>Massive <\/a>hemoptysis is a life-threatening respiratory emergency that needs urgent treatment. <\/ins>The mortality rate is very high when massive <\/a>hemoptysis is treated by conservative and the emergent surgical treatment [5<\/a>]. For these, BAE is a well-accepted and widely used intervention in the treatment of recurrent and massive hemoptysis [13<\/a>]. It is well known that bronchial arteries makes up<\/ins> over 90%<\/ins> of cases of<\/ins> <\/a>hemoptysis<\/ins> <\/ins>[14<\/a>].<\/ins> <\/ins>P<\/ins>ulmonary arteries<\/ins> are<\/ins> also<\/ins> possible<\/ins> <\/ins>sources of the bleeding<\/ins>.<\/ins> <\/ins>Moreover, nonbronchial arteries including branches of the<\/ins> thyrocervical trunk,<\/ins> <\/ins>internal mammary artery,<\/ins> axillary artery,<\/ins> <\/ins>subclavian artery<\/ins> and the inferior phrenic artery are responsible for bleeding in hemoptysis<\/ins> [15<\/a>].<\/ins> <\/ins>These vascular<\/ins>s<\/ins> should be<\/ins> embolized<\/ins> <\/ins>adequately<\/ins> to ensure effective<\/ins> management<\/ins> <\/ins>of hemoptysis<\/ins> <\/ins>[16<\/a>].<\/ins> I<\/ins>n the current case,<\/ins> the<\/ins> right intercostal artery, right bronchial artery, right subclavian arterial branch, right internal thoracic artery and right thyrocervical trunk<\/ins> <\/ins>were<\/ins> <\/ins>embolized successfully<\/ins>.<\/ins> <\/ins>w<\/del>ith<\/del><\/p>\n

<\/ins> It is routine to perform BAE via the access of femoral artery<\/ins> [9-11<\/a>]. Generally, bleeding vessels can be found and embolized successfully. While<\/ins> t<\/ins>he radial<\/ins> artery<\/ins> a<\/ins>ccess<\/ins> <\/ins>to BAE<\/ins> has<\/ins> many<\/ins> advantages over the<\/ins> <\/ins>femoral<\/ins> artery access<\/ins>. The hand has a dual blood<\/ins> supply,<\/ins> reducing<\/ins> the potential<\/ins> <\/ins>for limb-threatening ischemia.<\/ins> <\/ins>B<\/ins>ecause t<\/ins>he<\/ins> <\/ins>radial artery<\/ins> <\/ins>is<\/ins> superficial<\/ins>, this access<\/ins> <\/ins>decreases the r<\/ins>isk of<\/ins> nerve injury<\/ins> and<\/ins> <\/ins>local hematoma<\/ins>.<\/ins> The safety of<\/ins> radial<\/ins> artery<\/ins> access in<\/ins> percutaneous interventions<\/ins> and<\/ins> coronary angiography<\/ins> has been<\/ins> <\/ins>confirmed in several studies<\/ins> relative<\/ins> to transfemoral<\/ins> <\/ins>access<\/ins> [17<\/a>, 18<\/a>].<\/ins> The most common complications of transradial access<\/ins> are<\/ins> r<\/ins>adial artery spasm and thrombotic occlusion<\/ins> <\/ins>[19<\/a>].<\/ins> <\/ins>The<\/ins> current<\/ins> case<\/ins> showed<\/ins> that a transradial approach<\/ins> <\/ins>can be safe and effective in performing<\/ins> BAE<\/ins> when femoral access is undesirable.<\/ins><\/p>\n

W<\/ins>ith<\/ins> rapid visualization by CTA and the development of embolic materials, the efficacy of BAE has improved and the complications have decreased. <\/ins><\/p>\n

<\/del> Diagnostic interventions are important and necessary <\/a>for the planning and success [13]<\/a>of the treatment, including detection of the cause and location of bleeding. CTA is one of the most common approaches used for the detection of <\/a>hemoptysis causes [16<\/a>]. The modern CTA scan decreases the time of scanning and makes the process of scanning feasible in critically ill patients. However\u00ef\u00bc\u0152<\/del>,<\/ins> the patient in this case refused to receive<\/ins> CTA examination, thus, it is very difficult to find all the lesion vessels to increase the chances of recurrence of hemoptysis. Recurrences were observed at 6 months following embolization. <\/a>The cause is likely to be incomplete<\/ins> <\/ins>emboli<\/del>sed<\/del> <\/del>emboli<\/ins><\/del>zed<\/ins><\/del> <\/ins><\/del>embolization<\/ins> incomplete<\/del>ly<\/del> <\/del>to an undetected non-bronchial systemic<\/del> arterial supply,<\/ins> recanaliz<\/ins>ation of<\/ins> previously<\/ins> <\/ins>embolized vessels<\/ins>,<\/ins> pulmonary tuberculosis<\/ins> <\/ins>progression<\/ins>,<\/ins><\/del> <\/ins> <\/del>or secondary trauma because of failure of BAE<\/ins> via<\/ins> the femoral artery access<\/ins> <\/ins>and secondary<\/ins> <\/ins>result<\/del>ing<\/del> from<\/del> t<\/del>wo<\/del> embolizations<\/del> <\/ins>embolization<\/ins><\/del> via the<\/ins><\/a>radial artery access<\/ins>. [14]<\/a><\/p>\n

The choice of embolic materials is vital for BAE outcomes.<\/a> P<\/del>VA<\/del> <\/del>particles<\/del> <\/del>><\/del> <\/del>250 microns were<\/del> applied<\/del> in all the cases for<\/del> BAE<\/del>.<\/del> <\/del>Particles < 250 microns should be prohibited<\/del> because the passage of agents<\/del> through bronchopulmonary may<\/del> result in ischemia and necrosis<\/del> <\/del>in the lung<\/del> tissue<\/del> <\/del>.<\/del> PVA<\/ins> <\/ins>and<\/ins> <\/ins>a<\/ins>bsorbable gelatin sponge particles<\/ins> are<\/ins> <\/ins>most widely used<\/ins> due to that<\/ins> they are<\/ins> relatively<\/ins> <\/ins>inexpensive,<\/ins> <\/ins>easy to handle, and<\/ins> can be<\/ins> <\/ins>controlled<\/ins> on the basis of<\/ins> embolic siz<\/ins>e<\/ins> [16<\/a>, 20<\/a>].<\/ins> <\/ins>M<\/del>oreover<\/del>However<\/ins>, PVA may leads to permanent occlusion relative to gelatin sponge particles <\/ins>[21<\/a>]. BAE with<\/ins> n<\/ins>\u2013<\/ins>b<\/ins>utyl-2-<\/ins>c<\/ins>yanoacrylate<\/ins> (<\/ins>NBCA<\/ins>)<\/ins> provided higher hemoptysis-free survival rates<\/ins> relative to<\/ins> PVA particles<\/ins> <\/ins>[22<\/a>].<\/ins> <\/ins>M<\/ins>oreover,<\/ins> NBCA<\/ins> <\/ins>has gained<\/ins> more<\/ins> interest for control<\/ins> <\/ins>of bleeding because<\/ins> <\/ins>of rapid and complete occlusion<\/ins> <\/ins>of target vessels<\/ins> <\/ins>[23<\/a>].<\/ins> W<\/ins>hile,<\/ins> it<\/ins> bring<\/ins>s<\/ins> about<\/ins> a high risk<\/ins> <\/ins>for complications, such as t<\/ins>issue<\/ins> <\/ins>necr<\/ins>osis and<\/ins> uncontrolled reflux<\/ins> [16<\/a>, 24<\/a>].<\/ins> <\/ins>T<\/ins>hus,<\/ins> further clinical and exper<\/ins>imental<\/ins> researche<\/ins>s<\/ins> <\/ins>are<\/ins> required<\/ins> to<\/ins> observe<\/ins> <\/ins>the effectiveness and safety of<\/ins> <\/ins>these<\/ins> embolic materials<\/ins>.<\/ins><\/p>\n

Several complications related with BAE have been reported in the previous literatures. Chest pain is the most common complication of BAE, the occurrence rate is 24-91% [25<\/a>]. There are some rare complications reported previously, including bronchoesopha-geal fistula [26<\/a>], ischaemic colitis, pulmonary infarction, ischemia of the spinal cord and transient cor\u00adtical blindness [16<\/a>]. Among these, the most disastrous event is spinal cord ischemia caused by spinal arterial occlusion. More than 250 microns of particles are big enough to not occlude spinal arteries distally <\/ins>[27<\/a>]. In the current study, the patient had no compli\u00adcations published and mentioned above in the period of follow-up. This result suggested that it is feasible to perform BAE via the access of radial artery. This also may be due to the limited patients in the study.<\/p>\n

In conclusion, radial artery access might increase the effectiveness and success rate of BAE, benefitting patients with hemoptysis. Nevertheless, few cases have been reported. More clinical and experimental researches are needed to confirm the safety and effectiveness in the treatment of hemoptysis, and its clinical use should be elucidated.<\/p>\n

<\/a>L<\/strong>egends<\/strong>[15]<\/a><\/p>\n

Figure 1<\/strong> A<\/strong><\/ins>ngiographies of<\/strong><\/ins> r<\/strong><\/ins>ight intercostal artery, right bronchial artery, right subclavian arterial branch, right internal thoracic artery and right thyrocervical trunk<\/strong><\/ins> in 6<\/strong><\/ins>3<\/strong><\/ins>-year-old<\/strong><\/ins> woman.<\/strong><\/ins> Polyvinyl alcohol (PVA)<\/ins> particles embolized the right intercostal artery<\/del> and right bronchial<\/del>these<\/ins> artery<\/del>arter<\/ins>ies<\/ins>. A. The right intercostal artery was filled with polyvinyl alcohol<\/del> <\/del>particles<\/del>PVA<\/ins>. Angiography did not display disordered vessels in the distal end, indicating that the right intercostal artery was completely embolized. B. The right bronchial artery was filled with polyvinyl alcohol<\/del> PVA<\/ins> particles. Angiography did not display disordered vessels in the distal end, suggesting complete embolization of the right bronchial artery<\/del>.<\/del><\/p>\n

Figure 2<\/strong><\/del> Polyvinyl alcohol particles embolized the right subclavian arterial branch and right internal thoracic artery. A<\/del> <\/ins>C<\/strong><\/ins>. The right subclavian arterial branch was filled with polyvinyl alcohol<\/del>PVA<\/ins> particles. Angiography did not display disordered vessels in the distal end, indicating that t<\/del>he right subclavian artery was completely embolized. B<\/del>D<\/ins>. The right internal thoracic artery was filled with polyvinyl alcohol<\/del>PVA<\/ins> particles. Angiography did not display disordered vessels in the distal end, suggesting complete embolization of the right<\/del> internal thoracic artery<\/del>.<\/del><\/p>\n

Figure 3<\/strong><\/del> <\/del><\/p>\n

A<\/del>E<\/strong><\/ins>. The right thyrocervical trunk was filled with polyvinyl alcohol<\/del>PVA<\/ins> particles. Angiography did not display disordered vessels in the distal end, indicating that the right<\/del> thyrocervical trunk<\/del> was completely embolized. B<\/del>F<\/ins>. Angiography displayed a lesion vessel at the vertebral artery side of the right subclavian artery. <\/ins><\/p>\n

Figure 4<\/strong><\/del><\/p>\n

    \n
  1. <\/a>G.<\/ins> Angiographies of radial artery access to subclavian artery. B<\/del>H<\/ins>. <\/a>The condition of cobra catheter before shaped. C<\/del>I<\/ins>. The condition of cobra catheter after shaped. D<\/del>J<\/ins>. Angiography displayed that the lesion artery was completely embolized, indicating a good outcome.<\/li>\n<\/ol>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    Study Bay Coursework Assignment Writing Help Radial artery access to bronchial artery embolization for massive hemoptysis: a case report Abstract Background: Massive hemoptysis is a\u2026<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7641,8827,10535,10533,10534,10531,10529,6744,10532,10530,7741],"tags":[10553,10549,10616,10615,7687,10254,10627,10104,10247,8857,10552,10295,10900,2984,3903,10548,10622,8901,10551,8907],"class_list":["post-129391","post","type-post","status-publish","format-standard","hentry","category-australia-essay-writers","category-australia-essays","category-do-my-university-assignment-for-me","category-essay-pro-dissertation-writers","category-homework-help-services-best-websites","category-i-need-help-writing-a-page-paper-assignment","category-masters-essays","category-nursing-studybay","category-pay-someone-to-write-a-paper-for-you","category-website-that-writes-assignments","category-studybay","tag-1-assignment-help-online-service-for-students-in-the-usa","tag-ai-plagiarism-free-essay-writing-tool","tag-australian-best-tutors","tag-best-trans-tutors","tag-buy-essay-uk","tag-can-someone-write-my-assignment-for-me","tag-cheap-dissertation-writer","tag-essypro","tag-help-me-write-my-dissertation","tag-help-with-writing-an-essay","tag-help-write-my-paper-ai-free","tag-homework-for-you","tag-nursing-bay","tag-nursing-essay","tag-nursing-study-bay","tag-online-essay-writers","tag-phd-essays","tag-studbay","tag-write-my-assignment-help-for-college-students","tag-write-my-essay-for-me"],"_links":{"self":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/129391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/comments?post=129391"}],"version-history":[{"count":0,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/129391\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/media?parent=129391"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/categories?post=129391"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/tags?post=129391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}