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Record W3193410862 · doi:10.1016/j.jacc.2021.05.055

Global Chronic Total Occlusion Crossing Algorithm

2021· review· en· W3193410862 on OpenAlex
Eugene B. Wu, Emmanouil S. Brilakis, Kambis Mashayekhi, Etsuo Tsuchikane, Khaldoon Alaswad, Mario Araya, Alexandre Avran, Lorenzo Azzalini, А. М. Бабунашвили, Baktash Bayani, Michael Behnes, Ravinay Bhindi, Nicolas Boudou, Marouane Boukhris, Nenad Božinović, Leszek Bryniarski, Alexander Bufe, Christopher E. Buller, M. Nicholas Burke, Achim Buttner, Pedro Cardoso, Mauro Carlino, Ji-yan Chen, Evald Høj Christiansen, Antonio Colombo, Kevin Croce, Félix Damas de los Santos, Tony De Martini, Joseph Dens, Carlo Di Mario, Kefei Dou, Mohaned Egred, Basem Elbarouni, Ahmed ElGuindy, Javier Escaned, Sergey Furkalo, Andrea Gagnor, Alfredo R. Galassi, Roberto Garbo, Gabriele Gasparini, Junbo Ge, Lei Ge, Pravin K. Goel, Ömer Göktekín, Nieves Gonzalo, Luca Grancini, Allison B. Hall, Franklin Leonardo Hanna Quesada, Colm G. Hanratty, Stefan Harb, S. Harding, Raja Hatem, Josè P.S. Henriques, David Hildick‐Smith, Jonathan Hill, Angela Hoye, Wissam Jaber, Farouc A. Jaffer, Yangsoo Jang, Risto Jussila, Artis Kalniņš, Arun Kalyanasundaram, David E. Kandzari, Hsien‐Li Kao, Dimitri Karmpaliotis, Hussien Heshmat Kassem, Jaikirshan Khatri, Paul Knaapen, Ran Kornowski, Oleg Krestyaninov, Ashish Kumar, Pablo Lamelas, Seung‐Whan Lee, Thierry Lefèvre, Raymond Leung, Yu Li, Yue Li, Soo-Teik Lim, S. Lo, William Lombardi, Anbukarasi Maran, Margaret McEntegart, Jeffrey W. Moses, Muhammad Munawar, Andrés Navarro, Hung Manh Ngo, William Nicholson, Anja Øksnes, Göran Olivecrona, Lucio Padilla, Mitul Patel, Ashish Pershad, Marin Postu, Jie Qian, Alexandre Schaan de Quadros, Nidal Abi Rafeh, Truls Råmunddal, Vithala Surya Prakasa Rao, Nicolaus Reifart, Robert F. Riley, Stéphane Rinfret, Meruzhan Saghatelyan, George Sianos, Elliot J. Smith, Anthony Spaedy, James Spratt, Gregg W. Stone, Julian Strange, Khalid Tammam, Craig A. Thompson, Aurel Toma, Jennifer A. Tremmel, Ricardo Santiago Trinidad, Imre Ungi, Minh Vo, Vũ Hoàng Vũ, Simon Walsh, Gerald Werner, Jarosław Wójcik, Jason Wollmuth, Bo Xu, Masahisa Yamane, Luiz F. Ybarra, Robert W. Yeh, Qi Zhang

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueJournal of the American College of Cardiology · 2021
Typereview
Languageen
FieldMedicine
TopicCoronary Interventions and Diagnostics
Canadian institutionsLondon Health Sciences CentreWestern UniversityUniversité de MontréalRoyal Columbian HospitalHôpital du Sacré-Cœur de MontréalMcGill University Health CentreTeleflex (Canada)Royal Alexandra HospitalMcMaster UniversitySt. Michael's HospitalSt. Boniface HospitalMemorial University of NewfoundlandUniversity of Manitoba
FundersInfraRedxAbiomedTherOxAbbott VascularRegeneron PharmaceuticalsBoston Scientific CorporationCardinal HealthAmgenEdwards LifesciencesAmerican Heart AssociationDaiichi Sankyo EuropeSanofiDaiichi-SankyoAstraZeneca
KeywordsMedicineOcclusionLumen (anatomy)Collateral circulationIntravascular ultrasoundRadiologyAlgorithmCardiologySurgeryComputer science

Abstract

fetched live from OpenAlex

The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.

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.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.982
Threshold uncertainty score0.616

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0040.003
Bibliometrics0.0000.001
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.022
GPT teacher head0.354
Teacher spread0.331 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it