Recurrent TIPS dysfunction and variceal bleeding: A combined, staged, use of large-bore aspiration thrombectomy and partial splenic artery embolization—A case report
Bibliographic record
Abstract
A 51-year-old man, with a history of cirrhotic portal hypertension and recurrent transjugular intrahepatic portosystemic shunt (TIPS) stenoses, presented with an acute gastro-esophageal variceal hemorrhage in the setting of an acute and massive thrombotic TIPS shunt occlusion. The clinical presentation was complicated by patient's severe, chronic thrombocytopenia which had precluded empiric anticoagulation previously for recurrent TIPS dysfunction. Following endoscopic treatment of the variceal bleeding, the CAT 12 Indigo aspiration system (Penumbra) was used to remove a large burden of thrombus from the TIPS, allowing successful re-stenting and restoration of blood flow through the TIPS. A staged partial splenic artery embolization was performed a few days later to reduce hypersplenism and treat the thrombocytopenia. The patient was then therapeutically anticoagulated to prevent future TIPS occlusion.
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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 | 0.000 | 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 | 0.000 | 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".