Navigating severe vascular tortuosity and cervical carotid loop management in stroke thrombectomy: A case report and review of the literature
Bibliographic record
Abstract
Endovascular therapy is the current gold standard treatment for the management of acute ischemic stroke from large vessel occlusion. Despite this, the presence of severe vascular tortuosity and cervical carotid loops can hinder the success of the procedure. We present a case of an 83-year-old female presenting with acute ischemic stroke and extreme tortuosity including common carotid artery and internal carotid artery consecutive loops, as well as a tandem common carotid artery bifurcation thrombus with an M1 segment occlusion. Subsequently, relevant literature is reviewed regarding the technical management of complex thrombectomy cases. The endovascular procedure involved navigating through extreme vascular tortuosity using multiple endovascular tools for optimal reperfusion using delivery devices to facilitate the procedure. Challenges such as vasospasm and straightening of an internal carotid artery loop occurred during the procedure. However, successful thrombectomy was performed using adequate procedural techniques discussed.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".