Anatomical Advantage to Percutaneous Insertion of the Intra-Aortic Balloon through the Left Brachial Artery over the Right Brachial Artery
Bibliographic record
Abstract
Off-label use of the intra-aortic balloon (IAB) is not recommended in ideal situations and certainly not a Food and Drug Administration-approved activity. The instruction-for-use manual for the IAB recommends percutaneous insertion. However, there are certain extreme situations where “thinking outside the box” appears necessary. We have successfully inserted a transthoracic IAB (TIAB) in the operating room where an open sternum is an option. This has been instituted whenever severe peripheral vascular disease (PVD) precludes a percutaneous attempt or when attempted insertion fails. An open chest is not a choice in the catheterization laboratory or the postoperative setting. We have successfully inserted the IAB through the brachial/axillary artery in a patient with bilateral aortofemoral grafts, with a history of severe PVD, in the cardiac catheterization laboratory. A left-sided approach is advisable for brachial artery insertion and an axillary approach is also possible under sedation. This case report details our experience with transbrachial insertion of the IAB and establishes counterpulsation through this route as a viable option, where an open chest is not available and a percutaneous femoral approach has failed.
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 distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
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 teacher head, 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".