A “microcatheter anchor technique” to prevent prolapse and facilitate retrograde chronic total occlusion intervention via a retroflexed saphenous vein graft
Bibliographic record
Abstract
Chronic total occlusion percutaneous coronary intervention has lower success rates in patients with prior coronary artery bypass graft surgery. Patent or occluded bypass grafts serve as conduits for retrograde recanalization, but a common cause of failure is the acute angulated graft insertion making wiring difficult, with recurrent wire and microcatheter prolapse, if not impossible. We present a case with difficult retrograde wiring and tracking around a retroflexed graft insertion site that was successfully addressed using a strategic balloon to anchor the microcatheter – the “microcatheter anchor technique (MAT)”. • Patent or occluded bypass grafts serve as useful conduits for retrograde chronic total occlusion recanalization. • Acute angulated graft insertion sites make retrograde wiring and/or microcatheter advancement difficult. • The “microcatheter anchor technique” (MAT) facilitates retrograde wiring around retroflexed graft insertion sites. • This technique is simple and versatile with applications to other difficult coronary anatomies, outside CTO intervention.
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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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".