Abstract T P12: Intraarterial (IA) Iodinated Radiographic Contrast Media (IRCM) Effect in the Interventional Management of Stroke (IMS) III Trial
Bibliographic record
Abstract
Background: IRCM have variable anti-thrombotic, fibrinolytic, cytotoxic, hydrostatic, and vasoactive effects. IA low-osmolar iohexol (~700 mOsm/L) was associated with increased ICH in a rat MCA occlusion model compared to saline infusion. IA isosmolar iodixanol (280 mOsm/L) was associated with smaller infarcts and less ICH versus low-osmolar iopamidol and saline. Reduced odds of favorable outcome in patients receiving IV IRCM prior to IV rtPA has been suggested. No human stroke study has compared outcomes according to IA IRCM use. Methods: 133 IMS III subjects underwent endovascular therapy (EVT) for M1 occlusion. mTICI 2B-3 reperfusion, 90-day mRS 0-2, asymptomatic ICH, symptomatic ICH, and 90-day mortality were analyzed according to use of either iso-osmolar iodixanol (n=31) or low-osmolar IRCM (n=102). Separate adjusted models were fit for each outcome. Variables imbalanced between IRCM types or associated with outcome (p<0.1) were considered potential covariates for adjusted models, including antiplatelet medication (67.7% iodixanol vs. 44.1%, p=0.021), coronary artery disease history (35.5% iodixanol vs. 19.6%, p=0.067) and age (iodixanol median 73 vs. 68.5 yrs, p=0.070). Adjusted relative risks were estimated using a log-link regression model following stepwise selection of covariates. Results: % Differences for all specified outcomes in favor of the iodixanol group were identified. None of 11 baseline or EVT variables linked to outcome was in favor of the iodixanol group (p < 0.3). Unadjusted and adjusted relative risk point estimates were in favor of the iodixanol group for all specified outcomes (Table). Conclusion: While there were no significant differences, relative risk point estimates for relevant specified endpoints for M1 occlusion are in favor of iodixanol use. Small sample size limits ability to show significant differences. Data remains hypothesis-generating. Potential mechanisms warrant further investigation.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".