Cutting balloon angioplasty for aortic coarctation.
Bibliographic record
Abstract
BACKGROUND: Cutting balloon angioplasty (CBA) has improved outcomes for resistant stenotic vascular lesions in adult coronary artery disease. Application of this technique in coarctation of the aorta (CoA) in children has not been reported. OBJECTIVE: We sought to review the safety, efficacy and outcomes of CBA in the setting of CoA. METHODS AND RESULTS: Between February 2004 and October 2007, 8 children (4 males) underwent 10 procedures. The median age was 5.5 months (range: 2.5 months to 5 years) and median weight 7.5 kg (range: 4.1-13.3 kg). Two children had native CoA. CBA was employed due to a persistent waist after conventional balloon angioplasty (6 procedures) or as the primary dilatation (4 procedures). The cutting balloon diameter was a median 143% (range: 108-222%) of the diameter of the lesion. After dilatation, all children underwent further conventional balloon angioplasty. The CoA median diameter increased from 2.8 mm (range: 1.8-4 mm) to 4 mm (range: 2.9-6.7 mm; p = 0.0018), and the arm-to-leg blood systolic blood pressure gradient decreased from 38.5 mmHg (range: 2-70 mmHg) to 7 mmHg (0-30 mmHg; p < 0.0001). The median follow-up period was 4.6 months (range: 0.5-15.6 months), and 2 children required a second balloon dilatation. No aneurysm formation was observed acutely, although 2 children each developed a femoral arteriovenous fistula or a pseudoaneurysm. CONCLUSION: This early experience suggests that CBA is acutely safe and can be effective in the management of recalcitrant coarctation lesions in the young.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".