Prediction of Irregular Plaque Protrusion After Stenting by Magnetic Resonance Imaging Plaque Characterization

Background: One disadvantage of carotid artery stenting (CAS) is a high incidence of distal embolism (DE) during or after the procedure. Also, irregular plaque protrusion (PP) after stent placement has been suggested as one of the major causes of post procedural ischemic complications. The aim of this study was to evaluate the relationship between unstable plaque identified on black-blood magnetic resonance imaging (BB-MRI) and the occurrence of irregular PP after CAS using optical frequency domain imaging (OFDI). Materials and Methods: We enrolled 41 patients who underwent CAS with OFDI image acquisition. We measured signal intensity ratios (SIR) from T1 weighted images of all carotid plaques. The plaque with high SIR is considered as unstable plaque with intraplaque hemorrhage (IPH) according to previously published criteria. Cross-sectional OFDI images were evaluated at every 0.125-mm intervals within the stented segments, and assessed the relationships among the occurrence of irregular PP (I-PP), smoo...