E-002 Initial experience with the Penumbra stroke system for recanalization of large vessel occlusions in acute ischemic stroke
Bibliographic record
Abstract
Background The Penumbra system is a newly approved mechanical device for the treatment of acute stroke designed for better and faster recanalization. We describe our initial experience with the use of this device. Methods We studied 27 consecutive patients with acute ischemic stroke from January 2009 to October 2009 at our stroke centre. The primary outcome was the degree of reperfusion (TIMI grade 2/3) at end of the procedure. Secondary end points were the proportion of patients who achieved a modified Rankin Scale (mRS) ≤2 at 3 months, all cause mortality and intracerebral hemorrhage (ICH) on non-contrast CT at 24 h. Procedural complications such as vascular perforations, vasospasm, dissection, distal embolization and groin complications were recorded. Results 27 patients (13 men, mean age 61 years) were treated during the period January–October 2009. Median National Institutes of Health Stroke Scale on admission was 18 (range 3–32), median Alberta Stroke Program Early CT Score on non-contrast CT at admission was 8 (range 5–10) and median onset to intra-arterial treatment time was 192 min. 22 (81%) patients had anterior circulation strokes. 17 (63%) had intravenous tissue plasminogen activator initiated prior to angiography. 85% (23/27) patients achieved TIMI 2/3 grade reperfusion at completion of the procedure. 48% (13/27) patients had mRS ≤2 at the 3 month follow-up. Procedural complications included vasospasm (1/27), distal emboli (13/27) and ICH (seven HI1, one PH1 and one PH2). All cause mortality was 19% (5/27). Conclusions High reperfusion rates and good clinical outcomes are achievable with the Penumbra system. Complication rates are comparable with the previously published literature.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".