Cutting balloon angioplasty for resistant venous stenoses in hemodialysis patients
Bibliographic record
Abstract
Purpose: To report our initial experience of using cutting balloons angioplasty in the treatment of resistant venous stenoses of Brescia‐Cimino fistulas. Materials and Methods: Forty‐eight patients with Brescia‐Cimino fistulas underwent percutaneous transluminal angioplasty (PTA) of 62 venous stenoses. Of these 48 patients, we encountered 8 venous stenoses (8/62, 12.9%) in 7 patients that were not successfully dilated with 6–8 mm high‐pressure balloons inflated up to 24 atm. In each of 8 stenoses, peripheral cutting balloons with diameters of 5–8 mm were employed to dilate resistant stenoses. Results: The locations of stenoses were 3 at the surgical vein mobilization site (“swing point”), 4 at the cephalic vein downstream from the anastomosis, and 1 at the cephalic arch. The grade of stenosis after high‐pressure balloon angioplasty ranged from 57% to 87%(mean, 76%). Cutting balloons expanded completely in all stenoses and the residual stenosis after cutting balloon PTA ranged from 0% to 24%(mean, 7%). Residual stenosis was virtually nonexisistent at the 3 stenoses of “swing point.” A focal rupture with a large hematoma occurred at the cephalic arch stenosis, which was treated by a stent placement. One minimal rupture that did not require any treatment occurred at the stenosis of downstream cephalic vein. No repeat angioplasty has been needed during follow‐up period (range, 74–249 days). Conclusion: Our early experience demonstrated that when high‐pressure balloons fail to dilate stenoses of Brescia‐Cimino fistulas, peripheral cutting balloons with diameters of 5–8 mm can be effectively used to overcome the resistance of stenoses.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".