When brain and heart collide: a deeper dive into treatment pathways of stroke complicating TAVI
Bibliographic record
Abstract
Periprocedural ischemic stroke remains a major concern of transcatheter aortic valve implantation (TAVI). The aims of this study were to describe the incidence, characteristic, and outcomes of patients presenting with acute ischemic stroke complicating TAVI (AISCT), and to compare conservative management (CM) vs. neurointervention (NI), in eligible patients. We analyzed consecutive TAVI procedures performed in the Rabin Medical Center between 2008 and 2021. The patients with and without AISCT were compared. Outcomes of NI following AISCT were compared to CM. The primary outcomes were mortality at 1 and 3 years and neurologic disability status at 3 months. Of 1515 eligible patients who underwent TAVI between 2008 and 2021, 38 (2.5%) had AISCT within 30 days. All-cause mortality was significantly higher in the AISCT group in 30 days (13.9% vs. 2.4%, p < 0.01), 1 year (27.8% vs. 8.1%, p < 0.01), and 3 years (49.0% vs. 26.8%, p < 0.01), as compared to the AISCT negative group. Out of the 38 patients who suffered AISCT between 2008 and 2021, 7 underwent NI. The majority of AISCT were observed within the first 24-h following TAVI (p < 0.01). All-cause mortality following moderate/severe stroke was significantly higher (p = 0.037) compared to mild stroke. As compared to the CM, NI was not found to reduce mortality. However, patients with moderate severity stroke who underwent NI enjoyed a higher rate of disability free survival at 3 months (100% vs. 40%, p = 0.044), compared to patients treated conservatively. NI, as compared to CM, may improve disability status in eligible patients with moderate stroke.
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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 | 0.002 |
| 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".