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 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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".