RT Journal Article SR Electronic T1 Clinical and subclinical microemboli following neuroangiography in children JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 934 OP 938 DO 10.1136/jnis-2023-020686 VO 16 IS 9 A1 Alghamdi, Ibrahim A1 Dmytriw, Adam A A1 Amirabadi, Afsaneh A1 Lebarron, Samantha A1 Rea, Vanessa A1 Parra-Fariñas, Carmen A1 Muthusami, Prakash YR 2024 UL http://jnis.bmj.com/content/16/9/934.abstract AB Background To assess the frequency, imaging appearances, and risk factors of brain microemboli following pediatric neuroangiography, as assessed by early diffusion-weighted MRI imaging (DWI).Methods This single-center, retrospective analysis investigated early DWI post-pediatric neuroangiography. Patients aged 0–18 years who had diagnostic neuroangiography and DWI within a week postprocedure were included. Data on clinical and procedural parameters and MRI findings were recorded. Univariate and multivariate analyses were performed on the following risk factors: age, weight, vasculopathy, antiplatelet drug use, access type, intraprocedural heparin, procedure duration, neck arteries catheterized, and angiographic runs. A p-value<0.05 indicated statistical significance.Results Eighty-two children were included (40.2% female), mean age 10.1±4.5 years (range: 7 months–17 years). There were no intraprocedural thromboembolic complications recognized. DWI positivity was seen following 3.6% (3/82) procedures: two with transient symptoms, and one instance of silent microemboli. There were no territorial infarcts or clinical stroke. Children with underlying vasculopathy had a higher risk of microemboli from angiography than children without vasculopathy (OR 31.6, p=0.02), and the OR of microemboli following transradial angiography was 79.1 (p=0.005) as compared with transfemoral angiography. Univariate and multivariate analysis showed a significant association between microemboli and number of angiographic runs (p=0.004). Follow-up MRI in all three patients showed no residual abnormal signal.Conclusions Cerebral microemboli are unusual following uncomplicated neuroangiography in children. However, in the presence of underlying vasculopathy and with transradial technique, the incidence approaches that reported in the adult literature. An increased association with the number of angiographic runs is an important and controllable factor.All data relevant to the study are included in the article or uploaded as supplementary information.