Microcatheter navigation and thrombolysis in acute symptomatic cervical internal carotid occlusion.
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: The treatment of acute stroke distal to an occluded cervical internal carotid artery (ICA) presents a challenge. We report our results of endovascular therapy in 7 patients presenting with acute symptomatic cervical ICA occlusion. PATIENTS AND TECHNIQUES: Among patients presenting with acute stroke at our institution from June 2001 to June 2005, we retrospectively identified 7 patients who underwent endovascular therapy of acute cervical ICA occlusion. The techniques used for vessel recanalization were analyzed. Postprocedure CT scans were reviewed for hemorrhage. The clinical outcomes were assessed by using the modified Rankin scale (mRS) with good outcomes assigned scores of < or =2. RESULTS: All 7 patients revealed cervical ICA occlusion, with additional intracranial thrombus in 6 of the 7 patients. In all patients, a guiding catheter was placed in the ipsilateral common carotid artery proximal to the occlusion and a microcatheter advanced through the ICA clot to deliver intra-arterial (IA) tissue plasminogen activator (in 6 patients, the microcatheter was also advanced intracranially for thrombolysis). Successful recanalization of the occluded ICA was achieved in 6 patients. In 3 patients, balloon angioplasty and stent placement of the cervical ICA was also performed. Follow-up CT in 6 patients showed small basal ganglia infarcts in 4, patchy parietal infarcts in one, and frontal lobe hematoma in one patient. At 1 month after the procedure, 5 patients had good clinical outcomes (mRS of 0 in 4 patients and 1 in one patient). CONCLUSION: Performance of IA thrombolysis by passing a microcatheter through an acutely occluded internal carotid artery may be an effective therapy in acute stroke.
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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 | 0.000 | 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".