{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:27:59Z","timestamp":1760059679061,"version":"build-2065373602"},"reference-count":4,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Ischemic stroke following percutaneous coronary intervention (PCI) is a rare complication, with an overall incidence of 0.56%. Most embolic strokes result from the dislodgement of atherosclerotic plaques, thrombi formed on catheter surfaces, procedural maneuvers, or, less commonly, air or metallic emboli originating from fractured guidewires. We present a unique case of stroke following PCI due to a previously unreported mechanism\u2014arterial tunica media embolization associated with arterial access. A 57-year-old female presented with chest pain at rest and with exertion, accompanied by episodes of anxiety and fluctuating blood pressure, for which coronary angiography was performed, revealing 90\u201399% stenosis of the left anterior descending artery and necessitating PCI. During the procedure, the patient developed an eye deviation, aphasia, and left-sided hemiparesis. Cerebral angiography identified a M2 segment occlusion of the right middle cerebral artery (MCA) and a subocclusion of the right anterior cerebral artery (ACA). Thrombectomy was performed, retrieving two white, tubular emboli resembling fragments of a vessel wall, histologically confirmed to be arterial tunica media. While PCI is associated with a low complication rate, its increasing frequency necessitates awareness of emerging complications. This case underscores a previously undocumented potential embolic complication arising from the performance of PCI.<\/jats:p>","DOI":"10.3390\/diagnostics15131674","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T12:10:31Z","timestamp":1751285431000},"page":"1674","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ischemic Stroke Secondary to Arterial Tunica Media Embolism Following Percutaneous Coronary Intervention: An Uncommon Etiology"],"prefix":"10.3390","volume":"15","author":[{"given":"Patricija","family":"Gri\u0161kait\u0117","sequence":"first","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Radiology, Nuclear Medicine and Medical Physics, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0021-2923","authenticated-orcid":false,"given":"Neringa","family":"Jansevi\u010di\u016bt\u0117","sequence":"additional","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Radiology, Nuclear Medicine and Medical Physics, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Givi","family":"Lengvenis","sequence":"additional","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Radiology, Nuclear Medicine and Medical Physics, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kipras","family":"Mikelis","sequence":"additional","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Radiology, Nuclear Medicine and Medical Physics, 03101 Vilnius, Lithuania"},{"name":"Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Cardiac and Vascular Diseases, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mindaugas","family":"Zaikauskas","sequence":"additional","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Cardiac and Vascular Diseases, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9502-0631","authenticated-orcid":false,"given":"Marius","family":"Kurminas","sequence":"additional","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Radiology, Nuclear Medicine and Medical Physics, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-4957","authenticated-orcid":false,"given":"Andrius","family":"Ber\u016bk\u0161tis","sequence":"additional","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Cardiac and Vascular Diseases, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Algirdas Edvardas","family":"Tamo\u0161i\u016bnas","sequence":"additional","affiliation":[{"name":"Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Radiology, Nuclear Medicine and Medical Physics, 03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.carrev.2021.12.007","article-title":"Radial Artery Access Complications: Prevention, Diagnosis and Management","volume":"40","author":"Roy","year":"2022","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e007386","DOI":"10.1161\/CIRCINTERVENTIONS.119.007386","article-title":"Transradial Artery Access Complications","volume":"12","author":"Sandoval","year":"2019","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e006761","DOI":"10.1161\/CIRCINTERVENTIONS.118.006761","article-title":"Stroke After Percutaneous Coronary Intervention in the Era of Transradial Intervention: Report from a Japanese Multicenter Registry","volume":"11","author":"Shoji","year":"2018","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1016\/j.jacc.2010.01.039","article-title":"The Transradial Approach to Percutaneous Coronary Intervention","volume":"55","author":"Rao","year":"2010","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/13\/1674\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:01:50Z","timestamp":1760032910000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/13\/1674"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":4,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["diagnostics15131674"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15131674","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,6,30]]}}}