Screening for abdominal aortic aneurysms during cardiac catheterization.
Bibliographic record
Abstract
BACKGROUND: Many authorities advocate routine screening for abdominal aortic aneurysms (AAA). Patients undergoing cardiac catheterization often have risk factors for AAA. The purpose of this study was to evaluate the clinical utility of screening for AAA during cardiac catheterization. METHODS: We prospectively examined the abdominal aorta in 127 patients undergoing diagnostic cardiac catheterization. Panning down during left ventriculography was the primary method for imaging the abdominal aorta. However, if there was difficulty advancing the catheter into the abdominal aorta, a formal postero-anterior abdominal aortogram was obtained. Off-line analysis of aortic morphology and diameters was performed. RESULTS: We achieved adequate visualization of the abdominal aorta in 99 of 127 patients. Mean age was 67 years; 75% were male. Risk factors for AAA were common, and included: history of smoking (88%); angina (84%); hypertension (57%); hyperlipidemia (52%); previous myocardial infarction (39%); diabetes mellitus (30%); obesity (21%); congestive heart failure (17%); presence of peripheral vascular disease (14%); and previous peripheral vascular procedures (12%). Panning down during left ventriculography was performed in 89% of cases in the 30 degrees right anterior oblique position. Previously undiagnosed, asymptomatic abdominal aortic aneurysms were found in 8 of 99 patients (8%). The mean intraluminal aneurysmal diameter was 2.8 +/- 1.1 cm and the mean length was 5.4 +/- 1.8 cm. Abdominal ultrasonography was performed in 7 of these cases (1 patient refused), and the mean diameter measured was 3.8 +/- 1.4 cm. Peripheral vascular disease, previous peripheral vascular surgery and difficulty advancing the catheter during the procedure were associated by univariate analysis with the presence of AAA. Multivariate analysis demonstrated that difficulty threading the catheter was the only independent predictor of the presence of AAA (odds ratio = 11.1; 95% confidence interval = 4.6-26.6; p = 0.007). CONCLUSION: Undiagnosed abdominal aortic aneurysms can be identified during routine examination of the abdominal aorta during cardiac catheterization. Because screening for AAA during cardiac catheterization is inexpensive and easily performed, it should be a routine part of the examination.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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 | 0.001 |
| 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".