Carbon Dioxide Digital Subtraction Angiography for Central Venous Recanalization in a Kidney Transplant Patient: A Case Report
Bibliographic record
Abstract
ABSTRACT Background We present the case of a kidney transplant recipient with elevated serum creatinine who developed left upper limb swelling due to left subclavian vein thrombosis. Concerned about potential hemodialysis resumption, the patient prioritized preserving their arteriovenous fistula. Methods To address the swelling and maintain fistula function, central venous recanalization was necessary. Given the risk of iodine contrast‐induced acute kidney injury, particularly with elevated creatinine, the patient opted for carbon dioxide (CO 2 ) angiography. Following forearm fistula puncture, a catheter was inserted, and 50 mL of CO 2 was injected. Angiography revealed a left subclavian vein filling defect and stenosis, preventing guidewire passage. The stenosis was dilated using an 8 mm × 20 mm balloon, followed by implantation of a 6 mm × 10 mm vascular stent. Postintervention CO 2 angiography confirmed successful vein opening. Oral rivaroxaban was prescribed for anticoagulation. Results The patient's limb swelling gradually resolved, and serum creatinine remained stable. Conclusion CO 2 ‐DSA represents a potentially viable alternative imaging modality for patients requiring vascular interventions who are at elevated risk of iodinated contrast‐induced nephropathy.
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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) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 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".