Hybrid Surgical and Radiological Revascularization for Diabetic and Non-Diabetic Lower Limb Ischaemia
Bibliographic record
Abstract
Background: Multi-level occlusive arterial disease involving the iliac and distal arteries can be treated with major bypass, sequential or single stage radiological and surgical procedures. We report our experience with the single stage hybrid approach. Methods: All patients who underwent hybrid intervention between June 2008 and June 2011 were reported. Patients deemed medically unfit for major bypass or with insufficient veins were mainly considered. Prospective database of patients, procedures and complications with retrospective review of inpatient, outpatient and operative notes, computed tomographic angiography and duplex scan was performed. Results: Twenty three patients underwent 24 single stage procedures. The patient age ranged from 49 to 88 years (mean 70) with 19 males. Fifteen (65%) patients presented with intermittent claudication, 12 (52%) with short distance ( ≤ 100 yards) claudication, 12 (52%) with tissue loss and 8 (35%) with rest pain. Overall, 18 (78%) patients were presented with critical ischemia limb. The commonest procedures were iliac angioplasties with endarterectomies or bypasses, 23 out of 24 procedures (96%) were technically successful and 20 out of 22 patients (91%) followed up had clinically successful outcome. The mean ankle brachial pressure index improved from 0.57 to 0.71. Two patients (9%) died, 2 patients (9%) developed severe complications and 6 patients (26%) developed moderate complications within 30 days. Conclusion: Single stage hybrid radiological and surgical procedure for lower limb ischemia is feasible providing high technical and clinical success in patients unfit for major bypass or with limited vein conduit. It saves one admission providing patient convenience and potential cost savings. doi: http://dx.doi.org/10.4021/jcs101w
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".