Intracranial Angioplasty Utilizing the Comaneci Device As Bailout in Very Late Thrombectomy for Ischemic Stroke
Bibliographic record
Abstract
Endovascular management of ischemic stroke has been established as an effective treatment option. Nevertheless, restrictive selection criteria and limited device availability may delay recanalization in certain cases, particularly in developing countries. This report describes a resource-driven, off-label use of the Comaneci device in a patient with ischemic stroke presenting beyond the 24-hour window. A 61-year-old male arrived 28 hours after last known well (LKW). Despite initial clinical improvement with medical therapy alone, neurological deterioration occurred 2 days after onset. Primary aspiration thrombectomy achieved incomplete recanalization (mTICI 1, antegrade reperfusion but limited distal branch filling), revealing underlying intracranial atherosclerosis. Due to a lack of standard angioplasty tools, mechanical angioplasty with a Comaneci petit device was performed, improving perfusion to mTICI 2c (near complete perfusion except for slow flow or distal emboli). At 3-month follow-up, the patient had no residual symptoms and achieved full recovery (National Institutes of Health Stroke Scale (NIHSS) 0, mRS 0). Endovascular management remains a critical component of stroke care. Further exploration of alternative and adaptable strategies may help expand treatment access in challenging clinical settings.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".