{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:02:25Z","timestamp":1788519745472,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ondokuz May\u0131s University Scientific Research Projects Coordination Unit (BAPKOB)","award":["PYO.TIP.1904.21.012"],"award-info":[{"award-number":["PYO.TIP.1904.21.012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Silent cerebral ischemia (SCI) is defined as a condition that can be detected by biochemical markers or cranial imaging methods but does not produce clinical symptom. This study aims both to compare the frequency of SCI in PCIs performed with right transradial access and left transradial access and to evaluate the influencing factors. Materials and Methods: A prospective, single-center study included 197 patients undergoing PCI via transradial access between November 2020 and July 2022. The patients were categorized into right radial and left radial groups. Neuron-specific enolase (NSE) values were measured and recorded before and 18 h after the procedure. A post-procedure NSE level higher than 20 ng\/dL was defined as SCI. Results: SCI occurred in 60 of the 197 patients. NSE elevation was observed in 37.4% (n = 37) of the right radial group and in 23.5% (n = 23) of the left radial group (p = 0.032). Patients with SCI had higher rates of smoking (p = 0.043), presence of subclavian tortuosity (p = 0.027), and HbA1c (p = 0.031). In the multivariate logistic regression analysis, the level of EF (ejection fraction) (OR: 0.958 95% CI 0.920\u20130.998, p = 0.039), right radial preference (OR: 2.104 95% CI 1.102\u20133.995 p = 0.023), and smoking (OR: 2.088 95% CI 1.105\u20133.944, p = 0.023) were observed as independent variables of NSE elevation. Conclusions: Our findings suggest that PCI via right radial access poses a greater risk of SCI compared to left radial access. Anatomical considerations and technical challenges associated with right radial procedures and factors such as smoking and low ejection fraction contribute to this elevated risk.<\/jats:p>","DOI":"10.3390\/medicina60081193","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T14:26:50Z","timestamp":1721744810000},"page":"1193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Analysis of Right vs. Left Radial Access in Percutaneous Coronary Intervention: Impact on Silent Cerebral Ischemia"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1173-8903","authenticated-orcid":false,"given":"Abdulkadir","family":"Kara","sequence":"first","affiliation":[{"name":"Department of Cardiology, Elbistan State Hospital, 46300 Kahramanmara\u015f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korhan","family":"Soylu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, 55270 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ufuk","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, 55270 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5103-0141","authenticated-orcid":false,"given":"Muhammet","family":"Uyanik","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Carsamba State Hospital, 55500 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-6941","authenticated-orcid":false,"given":"Metin","family":"Coksevim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, 55270 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahattin","family":"Avci","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Ondokuz Mayis University, 55270 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0140-6736(78)90500-7","article-title":"Transluminal dilatation of coronary-artery stenosis","volume":"311","year":"1978","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1177\/0003319716685670","article-title":"Comparison of Transradial and Transfemoral Approaches in Women Undergoing Percutaneous Coronary Intervention in China: A Retrospective Observational Study","volume":"68","author":"Jin","year":"2017","journal-title":"Angiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1177\/0003319716656714","article-title":"From Femoral to Radial Approach in Coronary Intervention","volume":"68","author":"Bianchi","year":"2017","journal-title":"Angiology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S0735-1097(03)00587-4","article-title":"Cholesterol emboli after invasive cardiac procedures","volume":"42","author":"Bashore","year":"2003","journal-title":"J. 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