ABSTRACT
Objective:To investigate the in-stent thrombosis after carotid artery stenting revealed by optical coherence tomography (OCT) and its possible risk factors.Methods:Consecutive patients with carotid artery stenosis underwent carotid artery stenting and intraoperative OCT between January 2015 and December 2019 were selected through the Stroke Registration Center of the Second Affiliated Hospital of Guangzhou Medical University and Nanjing Stroke Registry Program. The clinical characteristics of the patients were recorded, OCT images were analyzed, and postoperative in-stent thrombosis was observed. At the same time, OCT image features such as plaque calcification, thin fiber cap, stent apposition, plaque prolapse and microdissection were collected. The risk factors for in-stent thrombosis were analyzed.Results:A total of 63 patients were included. OCT showed that 17 of them (23.3%) had in-stent thrombosis. Perioperative vascular events occurred in 4 patients due to in-stent thrombosis. One of them was more serious. There were no perioperative vascular events in the in-stent non-thrombosis group. Multivariate logistic regression analysis showed that microdissection was an independent risk factor for in-stent thrombosis after carotid artery stenting (odds ratio 5.439, 95% confidence interval 1.102-26.837; P=0.038). Conclusions:OCT can reveal in-stent thrombosis after carotid artery stenting, which was associated with perioperative vascular events, and microdissection was one of the possible causes of in-stent thrombosis.