Objective To investigate the safety and efficacy of percutaneous transluminal angioplasty(PTA)ver-sus percutaneous transluminal angioplasty and stenting(PTAS)in the treatment of symptomatic intracranial atherosclerotic stenosis(sICSA)with different clinical features.Methods A retrospective analysis was performed for 93 surgical cases in The Affiliated Hospital of Southwest Medical University from September 2018 to May 2022,and according to the vascu-lar morphology,age,and surgical procedure of the patients,they were divided into PTA group with 56 patients and PTAS group with 37 patients.The two groups were compared in terms of general information,surgical success rate,the inci-dence rate of serious complications within 30 days after surgery,modified Rankin Scale(mRS)score at 3 and 6 months af-ter surgery,and the rate of recurrent stroke of responsible vessels at 1 year after surgery.Results In patients with MORI type C of diseased vessels,there were more patients in the PTA group than in the PTAS group.There were no significant dif-ferences in the remaining baseline characteristics between the two groups.There were no significant differences between the PTA group and the PTAS group in terms of the success rate of surgery(98.2%vs 100%),the incidence of serious com-plications within 30 days after surgery(3.6%vs 2.7%),the good prognosis rate at 3 months after surgery(92.7%vs 94.1%),the good prognosis rate at 6 months after surgery(94.5%vs 94.1%),and the rate of re-stroke within 1 year after surgery(3.6%vs 2.9%).Conclusion In the MORI classification C of diseased vessels,the safety of PTA was significantly higher than that of PTAS.There were no significant differences in the success rate of surgery,the incidence of serious periopera-tive complications,the postoperative effect and the rate of symptomatic restenosis at 1 year after surgery between the two groups.

Objective::Microchannels are associated with the progression of atherosclerotic vulnerable plaques. However, in patients with culprit optical coherence tomography (OCT)-defined plaque erosion, the knowledge of microchannels and culprit lesion vulnerability is limited. The aim of this study was to investigate culprit lesion characteristics in patients with ST-segment elevated myocardial infarction (STEMI) caused by plaque erosion with and without microchannels using OCT.Methods::In all, 348 STEMI patients with plaque erosion who underwent OCT of the culprit lesion at the 2 nd Affiliated Hospital of Harbin Medical University (Harbin, China) from August 2014 to December 2017 were included and divided into the microchannel group ( n= 116, 33.3%) and no-microchannel group ( n = 232, 66.7%). The clinical characteristics and OCT-derived plaque features were compared between both groups. Results::Among the 348 STEMI patients with plaque erosion, culprit lesions with microchannels had higher incidence of lipid plaque (59.5% vs. 45.3%, P= 0.012); calcification (41.4% vs. 24.6%, P= 0.002); spotty calcification (30.2% vs. 18.1%, P= 0.014); macrophages accumulation (72.4% vs. 45.7%, P < 0.001); and cholesterol crystals (32.8% vs. 14.2%, P < 0.001) than those without microchannels. In addition, minimal lumen area was smaller ((1.9 ± 0.9) mm 2vs. (2.8 ± 2.3) mm 2, P < 0.001) and lumen area stenosis was greater ((71.3% ± 13.4%) vs. (65.3% ± 19.3%), P= 0.001) in the microchannel group than in the no-microchannel group. Conclusion::In patients with STEMI caused by plaque erosion, one-third manifested typical microchannel characteristics, and those with microchannels were associated with more severe luminal stenosis and more vulnerable plaque features than those without microchannels.

Objective::Microchannels are associated with the progression of atherosclerotic vulnerable plaques. However, in patients with culprit optical coherence tomography (OCT)-defined plaque erosion, the knowledge of microchannels and culprit lesion vulnerability is limited. The aim of this study was to investigate culprit lesion characteristics in patients with ST-segment elevated myocardial infarction (STEMI) caused by plaque erosion with and without microchannels using OCT.Methods::In all, 348 STEMI patients with plaque erosion who underwent OCT of the culprit lesion at the 2 nd Affiliated Hospital of Harbin Medical University (Harbin, China) from August 2014 to December 2017 were included and divided into the microchannel group ( n= 116, 33.3%) and no-microchannel group ( n = 232, 66.7%). The clinical characteristics and OCT-derived plaque features were compared between both groups. Results::Among the 348 STEMI patients with plaque erosion, culprit lesions with microchannels had higher incidence of lipid plaque (59.5% vs. 45.3%, P= 0.012); calcification (41.4% vs. 24.6%, P= 0.002); spotty calcification (30.2% vs. 18.1%, P= 0.014); macrophages accumulation (72.4% vs. 45.7%, P < 0.001); and cholesterol crystals (32.8% vs. 14.2%, P < 0.001) than those without microchannels. In addition, minimal lumen area was smaller ((1.9 ± 0.9) mm 2vs. (2.8 ± 2.3) mm 2, P < 0.001) and lumen area stenosis was greater ((71.3% ± 13.4%) vs. (65.3% ± 19.3%), P= 0.001) in the microchannel group than in the no-microchannel group. Conclusion::In patients with STEMI caused by plaque erosion, one-third manifested typical microchannel characteristics, and those with microchannels were associated with more severe luminal stenosis and more vulnerable plaque features than those without microchannels.