Longitudinal evaluation of tissue prolapse after carotid stenting by optical coherence tomography
10.3760/cma.j.cn113694-20231108-00301
- VernacularTitle:光学相干断层成像纵向评估颈动脉支架置入后组织脱垂
- Author:
Xuan SHI
1
;
Yunfei HAN
;
Xiaohui XU
;
Qingwen YANG
;
Fang WANG
;
Qin YIN
;
Rui LIU
;
Xinfeng LIU
Author Information
1. 南京大学医学院附属金陵医院（东部战区总医院）神经内科，南京 210002
- Keywords:
Tomography, optical coherence;
Carotid arteries;
Tissue prolapse;
Stents;
Neointimal hyperplasia
- From:
Chinese Journal of Neurology
2024;57(8):848-858
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the prevalence and type of tissue prolapse (TP) occurring after endovascular treatment (ET), investigate the association between TP types and plaque morphological characteristics before ET, and observe in-stent neointimal hyperplasia (NIH) using optical coherence tomography (OCT).Methods:Patients who underwent carotid artery stenting and received pre- and post-ET OCT assessment at Jinling Hospital between July 2018 and December 2019 were collected. Baseline plaque characteristics and TP features were evaluated using OCT. The TPs were classified into two categories: smooth TP (STP) and irregular and/or high attenuated TP (I/HTP). The association between I/HTP and plaque characteristics was analyzed, while NIH feature was also summarized.Results:A total of 29 patients were included in the study, of whom 23 patients (79.3%) presented with TP. Among these 23 patients, 9 were classified as I/HTP and 14 were classified as STP. Compared with STP, I/HTP was more commonly observed in lipid-rich plaques (7/9 vs 2/14, P=0.007), and lesions with cap rupture (7/9 vs 4/14, P=0.036). Additionally, the longitudinal length of TP appeared to be longer in cases with I/HTP compared to those with STP [3.0 (1.5, 4.6) mm vs 1.1 (0.7, 3.2) mm, Z=1.294, P=0.201]. Six patients underwent OCT follow-up for a mean duration of 6.7 months, of whom 3 patients with I/HTP showed severe heterogeneous NIH (50.1%-61.8%), while 1 patient with STP and 2 patients without TP only demonstrated mild NIH. Conclusions:The study observed that I/HTP was commonly found in plaques with larger lipid core and/or cap rupture, and suggested a potential relationship between I/HTP and NIH. These preliminary findings obtained from a limited sample should be verified by prospective large-scale studies.
