Pseudoaneurysm following transradial coronary angiogram
Bibliographic record
Abstract
A 54-year-old lady presented with Canadian cardiovascular society class II stable angina of 6 months duration. Clinical examination and investigations were unremarkable, including normal echocardiogram. She underwent elective coronary angiogram through right radial access, which revealed double vessel disease, and was discharged 6 h after the procedure. Two months afterwards, she presented with progressively enlarging swelling at the radial puncture site. Physical examination showed non-tender pulsatile hemispherical swelling on the volar aspect of right wrist (Panel A). Duplex ultrasound examination confirmed the presence of radial artery pseudoaneurysm measuring 29 × 22 × 15 mm, with a narrow neck of 2.7 mm (Panel B, arrow points to the neck of aneurysm). Spectral Doppler showed high velocity to and fro flow across the aneurysm neck (Panel C) and the classical yin-yang sign the characteristic swirling motion of blood in the aneurysm (Panel D). There was absence of distal flow in the radial artery, although the integrity of flow in the ulnar artery and palmar arch was preserved. In view of the large size of the aneurysm and its chronicity, patient was referred for surgical repair. Excision of the pseudoaneurysm and ligation of the radial artery was performed successfully (Panels E and F). She recovered well and subsequently underwent coronary angioplasty through the right femoral access. Patient is asymptomatic at 6 months follow-up with no recurrence of swelling. Access-related complications, although rare following radial procedures, is well recognized; meticulous care of arterial puncture site goes a long way in preventing this avoidable complication.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 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".