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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Published on: May 14, 2013

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Optical Coherence Tomography as an Adjunct During Carotid Artery Stenting for Carotid Atherosclerotic Disease

Christopher R Pasarikovski1, Joel Ramjist2, Leodante da Costa3

  • 1Division of Neurosurgery, Department of Surgery, University of Toronto, 399 Bathurst St., WW 4‑427, M5T 2S8, Toronto, ON, Canada. cpasarikovski2015@meds.uwo.ca.

Clinical Neuroradiology
|June 2, 2019
PubMed

Insights

Endovascular optical coherence tomography (OCT) safely identifies issues during carotid artery stenting (CAS), revealing plaque morphology and stent interactions. This imaging may guide future antithrombotic strategies to reduce stroke risk.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Carotid artery stenting (CAS) reduces stroke risk in symptomatic stenosis but carries periprocedural stroke risks.
  • Comparison with carotid endarterectomy shows higher stroke risk with CAS.
  • Need for improved intraprocedural monitoring during CAS.

Purpose of the Study:

  • To report the use of endovascular optical coherence tomography (OCT) during CAS.
  • To identify stent malapposition, plaque prolapse, and thrombus using OCT.
  • To assess OCT's role in preventing periprocedural stroke.

Main Methods:

  • Endovascular OCT imaging was approved and performed in patients undergoing CAS.
  • Images acquired before and after stenting.
  • Proximal balloon occlusion and saline flush used for clear luminal imaging.

Main Results:

  • Seven patients underwent OCT imaging without complications.
  • OCT revealed intraluminal thrombi, fibrous cap dissections, and thin-cap fibroatheromas.
  • Plaque herniation, thrombus, and poor stent apposition were visualized.

Conclusions:

  • Peri-procedural OCT imaging is safe and effective during CAS.
  • OCT provides valuable insights into plaque morphology and stent-vessel interactions.
  • Findings suggest re-evaluation of perioperative anticoagulation and potential role of OCT in guiding CAS and antithrombotic therapy.
Abstract

Keywords:
Carotid plaqueNeuroendovascularOCTStrokeThrombus

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