Abstract WP39: Radiographic Classification of ICA Occlusions Predicts Clinical Fluctuation and Post-Stenting Hemorrhage Risk
Bibliographic record
Abstract
Introduction: The optimal treatment strategy for symptomatic extra-cranial internal carotid artery (ICA) occlusion remains unknown. A radiographic classification of ICA occlusions has been proposed to help predict technical feasibility and the risk of complications with revascularization. The classification includes 4 main types (A-D) based on the morphology of the ICA stump (A having a tapered stump, B having a non-tapered stump, C and D having no stump) as well as the presence of reconstitution of flow in the intracranial ICA (C having reconstitution of the ICA within the cavernous and/or petrous segment and D having no reconstitution). In this study, we assess the predictive value of this classification scheme in understanding clinical phenotype and post-stenting complications. Methods: A retrospective review of a prospectively maintained database was conducted of clinical and radiological data from patients undergoing attempted angioplasty and stenting of complete symptomatic cervical ICA occlusion without tandem intracranial occlusion. Results: Seventy-two patients were included in the study, with a mean age of 63 years and 36% female gender. Classification type was as follows: 36% (type A), 25% (type B), 32% (type C) and 7% (type D). Revascularization was successful in 66/72 (92%) of patients. Clinical fluctuation prior to revascularization was most frequent in type A occlusions (p=0.02) and least frequent in type B occlusion (p=0.02). Only 8% of patients had peri-procedural intracerebral hemorrhage and the highest frequency occurred in group D (p=0.05). In a multivariate analysis, lower age, lower pre-treatment NIH Stroke Scale and favorable Alberta Stroke Program Early CT Score were predictors of higher modified Rankin Scale at 3 months (p=0.025, 0.004, 0.049, respectively). Conclusions: Radiographic classification of ICA occlusions can help classify patient phenotypes and potentially predict the technical safety of angioplasty and stenting. Prospective studies are warranted to confirm these findings.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".