E-105 Distal transradial access for targeted spinal angiography and embolization
Bibliographic record
Abstract
Background Spinal catheter angiography is indicated in the evaluation and treatment of spinal vascular lesions. The typical approach to spinal angiography consists of access through the femoral artery with the use of suitably shaped catheters for selective catheterization of the spinal segmental vasculature. We describe our experience with distal transradial access through the ‘anatomical snuffbox’ for targeted spinal angiography, to evaluate and treat selected vascular lesions in eight patients. Methods A retrospective review of patients who underwent transradial spinal angiography and embolization was performed from August 2019 to January 2022. A total of Eight patients were identified, who underwent targeted spinal angiography through distal transradial access. Results Seven patients had vascular tumors of the spinal column and underwent tumor embolization followed by segmental artery occlusion prior to surgery. One patient had a spinal dural AV fistula that could not be embolized due to feeding vessel tortuosity and eventually went on to have a laminectomy for disconnection of the fistula. None of the patients required conversion to femoral access. Mean total Fluoroscopy time was 31.4 minutes in the transradial angiography group compared to 35.9 minutes when similar procedures were performed by femoral access (n=9) during the study period. There were no access site hemorrhagic complications. One patient experienced transient mild hand numbness during the period of hemostasis with the vascular compression device that resolved completely within 24 hours. There were no instances of radial artery occlusion. Conclusion Distal transradial access is a feasible and safe option for targeted spinal angiography and treatment in selected patients. This may be used as an option in patients in whom femoral occlusive disease precludes traditional femoral arterial access. Disclosures M. Eesa: None. P. Lewkonia: None. A. Mitha: None.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.024 | 0.006 |
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".