Mechanical Thrombectomy in Ischemic Stroke: Current State of the Problem. Literature Review
Bibliographic record
Abstract
Механическая тромбэктомия является эффективным методом лечения ишемического инсульта. Многочисленные исследования, проведенные за последние годы, подтвердили ее безопасность и эффективность при лечении пациентов с окклюзией крупных сосудов переднего отдела кровообращения в течение 24 часов от начала инсульта. В 2015 году несколько крупных исследований (MR CLEAN, ESCAPE, SWIFT PRIME, REVASCAT и EXTEND IA) установили превосходство механической эндоваскулярной тромбэктомии над медикаментозным лечением инсультов. В этих испытаниях пациентов отбирали на основании локализации окклюзии (проксимальная передняя окклюзия: внутренняя сонная или средняя мозговая артерия), времени от начала инсульта (раннее окно до 6 часов) и приемлемой тяжести инфаркта (совокупный балл по шкале инсультной программы Альберты (ASPECTS) ≥6 или объем инфаркта <50 мл). Последующие испытания DAWN и DEFUSE 3 успешно расширили временное окно до 24 часов у надлежащим образом отобранных пациентов. Эти данные учтены в международных и национальных рекомендациях по ведению инсульта. Mechanical thrombectomy is an effective treatment for ischemic stroke. Numerous studies conducted in recent years have confirmed its safety and efficacy in the treatment of patients with occlusion of large vessels of the anterior circulation within 24 hours from the onset of a stroke. In 2015, several large studies (MR CLEAN, ESCAPE, SWIFT PRIME, REVASCAT and EXTEND IA) established the superiority of mechanical endovascular thrombectomy over medical treatment of stroke. In these trials, patients were selected based on the location of the occlusion (proximal anterior occlusion: internal carotid or middle cerebral artery), time from onset of stroke (early window up to 6 hours), and acceptable infarct severity (Alberta Stroke Program (ASPECTS) cumulative score ≥6 or infarct volume <50 ml). Subsequent trials of DAWN and DEFUSE 3 successfully extended the time window to 24 hours in appropriately selected patients. These data are taken into account in international and national guidelines for the management of stroke.
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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 | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".