Combined technique versus stent-retriever alone: Interaction analysis of angioarchitectural and technical features
Bibliographic record
Abstract
Introduction We aimed to explore if anatomical and technical features could interact and favor the chances of reperfusion according to the treatment strategy: combined technique (CoT) of mechanical thrombectomy (MT) with contact aspiration and stent-retriever (SR) versus SR alone. Methods Retrospective analysis of a prospective MT database for carotid terminus or MCA-M1 occlusion, first-line SR alone or CoT, and angiographic run with SR deployed on the first pass. The primary analysis involved the interaction between clinical and angiographic characteristics and first-line MT modality on first-pass effect (FPE; first pass eTICI2c-3). Results A total of 300 consecutive patients were included (SR alone, n = 210 vs CoT, n = 90). Baseline characteristics as well as baseline ASPECTS, CTA collateral score, clot burden score, FPE were similar amongst groups. Anatomical and technical variables (presence of reperfusion channel, frequency of SR position in dominant MCA division, angle of device-clot interaction, and clot length) were comparable between groups, with exception of SR opening (diameter across the occlusion) and length of SR purchase beyond the clot being more pronounced in the SR group. None of the clinical, anatomical, and technical factors were found to have an interaction with the MT strategy on the chances of FPE ( P-interaction ≥ 0.001). Multivariable logistic regression showed that clot burden score ≥8 (aOR 3.02, P = 0.003), angle of interaction (aOR 1.01, P = 0.015) but not the MT modality were associated with FPE. Conclusion No specific anatomical or technical features were observed to predispose to benefit when combining contact aspiration and SR thrombectomy. Clot burden score ≥ 8 and angle of interaction were independent factors associated with FPE. Additional studies are warranted.
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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 | 0.001 | 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".