Coronary Intra-neointimal Hyperplasia Hematoma After High-Pressure Dilation
Bibliographic record
Abstract
A 68-year-old man was admitted for unstable angina pectoris. Six months previously, he was treated with two zotarolimus-eluting stents (ZESs) (2.75×24.0mm and 3.50×18.0mm) implanted from the proximal left anterior descending artery (LAD) to the left main artery (LM), and one ZES (2.50×18.0mm) in the proximal left circumflex coronary artery (LCX) (T-stenting strategy). Repeat coronary angiography showed in-stent restenosis (ISR) in the ostial LCX (Figure 1A) which was treated using a 2.50×26.0mm drug-coated balloon, and then kissing balloon inflations with a 3.50×15.0mm non-compliant balloon in the LAD and a 2.50×12.0mm non-compliant balloon in LCX, both at 6atm. After final proximal optimization technique with a 3.50×15.0mm non-compliant balloon at 12atm, angiography showed that the LM appeared to have a new, moderate stenosis (Figures 1B and 1C, Online Videos 1 and 2). Intravascular ultrasound (IVUS) showed an intra-neointimal hyperplasia hematoma, which is a homogeneous in-stent structure with blood speckle in the false lumen and intima pushed inward to cause lumen compromise (Figure 1D, Online Videos 3 and 4). An additional everolimus-eluting stent (3.5×18.0mm) implantation successfully, compressing the hematoma (Figures 1E and 1F). The patient was free of clinical events for 4-years follow-up.
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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 | 0.002 |
| 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 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".