Hybrid Open and Endovascular Management of a Gunshot Wound to the Carotid Artery
Bibliographic record
Abstract
In addition to standard open surgical techniques, major hemorrhage is increasingly being managed using hybrid (open and endovascular) surgery. We present a case of hybrid management of a carotid artery injury secondary to an oropharyngeal gunshot wound. After performing balloon catheter tamponade with an inflated intraoral Foley catheter, on-table transfemoral angiography demonstrated extravasation from the external carotid artery with arteriovenous fistulization to the internal jugular vein. An endovascular stent graft was deployed, spanning from the common carotid to the internal carotid artery. This facilitated surgical neck exploration and ligation of the external carotid artery and jugular vein injury in zone II/III of the neck while maintaining antegrade cerebral blood flow. The approach presented represents a feasible and effective means to manage these types of difficult-to-access injuries in the endovascular and hybrid surgical era.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 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".