Transbrachial Catheter-Assisted Thrombolysis and Bailout Stenting for Massive Postoperative Pulmonary Embolism
Bibliographic record
Abstract
BACKGROUND: A 61-year-old patient developed acute dyspnea and hypoxemia 72 hours after open lung lobectomy. An urgent computed tomography angiography revealed an acute pulmonary embolism with complete left pulmonary artery occlusion. CASE SUMMARY: The patient was referred for urgent catheterization by a multidisciplinary team due to bleeding risks. Using right transbrachial access, the left pulmonary artery was recanalized. After balloon angioplasty, intravascular imaging guided the optimal placement of a stent to resolve vessel recoil. Local low-dose thrombolysis was initiated after partial reopening. After 24 hours, control angiography showed significant improvement in pulmonary artery perfusion. DISCUSSION: To our knowledge, this is the first reported case of using a coronary stent with local thrombolysis via brachial access to treat acute pulmonary embolism. The procedure successfully restored vessel patency with no complications. This case emphasizes the potential of catheter-based interventions, especially when intravenous thrombolysis is contraindicated. TAKE-HOME MESSAGE: Innovative catheter-based interventions with stenting and local thrombolysis via transbrachial approach may offer a valuable option for managing acute pulmonary embolism in select patients.
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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) | 0.001 | 0.000 |
| 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".