{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:39Z","timestamp":1789013319234,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Silent cerebral embolization frequently occurs after transradial cerebral angiography and is commonly detected on diffusion\u2010weighted imaging (DWI). However, the distribution patterns, burden, and procedural determinants of embolic lesions remain incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This prespecified secondary analysis of a randomized controlled trial evaluated embolic lesion patterns following transradial cerebral angiography under different heparin strategies. Patients with postoperative DWI were included. Lesion patterns were characterized by multiplicity, laterality, size, and overall burden. Multivariable Poisson regression identified factors associated with DWI\u2010positive lesions and lesion distribution patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 456 patients with evaluable postoperative DWI, embolic lesions were detected in 77 (16.9%). Most lesions were small (&lt;5\u2009mm [62.3%]) and cortical (61.0%), whereas 29.9% had multiple lesions and 22.1% had bilateral involvement. Fazekas grade \u22652 (adjusted risk ratio [RR], 2.38 [95% CI, 1.60\u20133.53];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and longer procedure duration (adjusted RR, 1.05 [95% CI, 1.02\u20131.08] per minute;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) were significantly associated with DWI\u2010positive lesions. Heparin strategy was not associated with overall lesion incidence. However, heparinization combined with continuous heparinized saline flush was significantly associated with multiple lesions (adjusted RR, 1.52 [95% CI, 1.01\u20132.28];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.044), bilateral involvement (adjusted RR, 1.21 [95% CI, 1.04\u20131.42];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.015), and high lesion load (adjusted RR, 2.86 [95% CI, 1.02\u20138.01];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.045).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Embolic lesions after transradial cerebral angiography show heterogeneous distribution patterns beyond incidence alone. Characterization of lesion multiplicity, laterality, and burden provides a more nuanced assessment of embolic injury. Continuous pressurized heparinized saline flush is associated with more diffuse lesion patterns, highlighting procedural and technical influences on embolic risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/chictr.org.cn\">chictr.org.cn<\/jats:ext-link>\n                      ; Unique Identifier: ChiCTR2400080902.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051166","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:19:22Z","timestamp":1785496762000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Embolic Lesion Patterns After Transradial Cerebral Angiography: A Secondary Analysis of a Randomized Controlled Trial"],"prefix":"10.1161","volume":"15","author":[{"given":"Chenchen","family":"Liu","sequence":"first","affiliation":[{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Provincial Clinical Research Center for Stroke","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1541-8529","authenticated-orcid":false,"given":"Peixin","family":"Li","sequence":"additional","affiliation":[{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2384-2298","authenticated-orcid":false,"given":"Tiancen","family":"Fan","sequence":"additional","affiliation":[{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Deng","sequence":"additional","affiliation":[{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Provincial Clinical Research Center for Stroke","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihui","family":"Wang","sequence":"additional","affiliation":[{"name":"Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Huazhong University of 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