Collaterals in the Interventional Management of Stroke (IMS) III Trial (P05.226)
Bibliographic record
Abstract
OBJECTIVE: To conduct a systematic analysis of collaterals on conventional angiography in the endovascular treatment arm of the Interventional Management of Stroke (IMS) III trial. BACKGROUND: Collateral circulation may exert an influential effect on arterial recanalization, downstream angiographic and tissue reperfusion and ensuing clinical outcomes after revascularization for acute ischemic stroke. Endovascular strategies provide unique opportunity to correlate definitive angiographic measures of collaterals at the time of interventional therapy. DESIGN/METHODS: Prospective evaluation of angiographic collaterals was conducted via central review of all cases enrolled and treated in the endovascular arm of IMS III. Collateral grade was assessed with the ASITN/SIR scale on angiography at procedure start and immediately prior to intra-arterial treatment (time 0), blind to all other data. Statistical analyses investigated the association between collateral grade with baseline clinical data, angiographic measures of recanalization (AOL), angiographic reperfusion (TICI), and clinical outcomes. RESULTS: From 2006-2012, 380 cases were prospectively evaluated for collateral grade at start of procedure and time 0 prior to treatment. Adequate collateral views were available in 283/380 (75%) cases at baseline, and 277/380 (73%) cases at time 0 and after subsequent treatment with intra-arterial tPA, EKOS, MERCI, Penumbra, and Solitaire devices. Detailed results will be presented at ISC in coordination with release of the primary trial results. The relationships between collateral flow grade and baseline clinical features (NIHSS and age), location of vascular occlusion at cerebral angiography, AOL recanalization and TICI reperfusion, and mROS of 0-2 at 90 days will be presented. Analyses will explore potential interactions between collateral flow grade with recanalization, angiographic reperfusion, and clinical outcome. CONCLUSIONS: Collateral circulation was available and prospectively evaluated in the largest endovascular therapy trial for stroke conducted to date. The role of collaterals may be an important consideration in the design of future endovascular trials. Supported by: NIH/NINDS K24NS072272, NIH/NINDS P50NS044378; NINDS-funded IMS III Trial, UC SPOTRIAS Center. Disclosure: Dr. Liebeskind has received personal compensation for activities with Concentric Medical, Inc. and CoAxia, Inc as a consultant. Dr. Tomsick has nothing to disclose. Dr. Yeatts has nothing to disclose. Dr. Foster has nothing to disclose. Dr. Carrozzella has nothing to disclose. Dr. Jovin has received personal compensation for activities with Covidien, Concentric Medical Inc., Stryker Consulting, and Silk Road Medical. Dr. Jovin has received personal compensation in an editorial capacity for Journal of Neuroimaging. Dr. Khatri has received personal compensation for activities with Janssen Pharmaceuticals as a consultant. Dr. Khatri has received research support from Penumbra Inc. Dr. Goyal has nothing to disclose. Dr. Palesch has nothing to disclose. Dr. Broderick has received personal compensation for activities as a speaker. Dr. Broderick has received research support from EKOS Corporation, Concentric Inc., and Genentech, Inc. Dr. The IMS III Investigators has nothing to disclose.
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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 | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".