Abstract 3846: Contrast Permeation In Hyperdense Artery Sign: Evidence Of Freshly Forming Thrombus Accumulating Around The Initial Clot? Pilot Data From The Interrsect Multicentre Thrombus Imaging Study.
Bibliographic record
Abstract
Introduction: Previous work has examined the importance of thrombus density impacting recanalization with systemic thrombolysis. The mechanism underlying thrombus density however is not well understood. RBC content is known to be high in hyperdense thrombi. We evaluated the relationship between density of thrombi and flow characteristics within and adjacent to thrombi in iv tPA treated patients in the INTERRSeCT pilot study. Methods: The pilot data analysed includes any patient (age > 40) with evidence of a visible and symptomatic thrombi on baseline CTA treated with IV t-PA as standard of care. Each patient enrolled in the study had early recanalization assessed on repeat CTA within 3-5 hours of baseline imaging. Imaging data were analyzed in a core-imaging lab. Hyperdense sign on NCCT, length and presence of contrast permeation through thrombus on CTA were assessed on 5 mm image slices using OSIRiX, an image processing software. Results: Of 101 patients enrolled in INTERRSeCT, 35 patients with MCA or intracranial ICA thrombi (mean age 70+− 12.5 yrs, 53% male) treated with IV t-PA were included in this analysis. The hyperdense sign (HDS) was seen in 22/35 (62.8%) and contrast permeation through thrombus was seen in 19/35 (54.2%). Median clot length was significantly higher in patients with HDS when compared to those without (2.46 cm vs 1.33 cm, p=0.03). We noted increased probability of contrast permeation in the presence of HDS (68.1% in HDS+ vs 30.7% in HDS-, p=0.03). ( Table and Figure ) HDS was associated with significantly lower early recanalization rates (36.3% in HDS+ vs 84.6% in HDS-, p=0.01). Conclusion: The evidence of contrast permeation, increased density and longer length of occlusion support the hypothesis that hyperdense artery sign represents freshly forming thrombus accumulating around the initial clot. These composite clots recanalize less with IV t-PA when compared to native clots. A larger cohort of patients is required to confirm these results.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".