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Clinical Neurology
Case series
Optical coherence tomography evaluation of vertebrobasilar artery stenosis: case series and literature review
  1. Xiaohui Xu1,
  2. Min Li1,
  3. Rui Liu1,
  4. Qin Yin1,
  5. Xuan Shi2,
  6. Fang Wang1,
  7. Jie Gao1,
  8. Gelin Xu1,
  9. Ruidong Ye1,
  10. Xinfeng Liu1,3
  1. 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
  2. 2 Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
  3. 3 Stroke Center & Department of Neurology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
  1. Correspondence to Dr Xinfeng Liu, Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China; xfliu2{at}vip.163.com

Abstract

Background Intracranial vertebrobasilar artery stenosis is an important cause of ischemic stroke. With its high resolution, intravascular optical coherence tomography (OCT) provides detailed assessment of vessel wall features. It is widely applied to identify high-risk plaque in the cardiovascular system, but its use in the intracranial artery has been limited.

Objective To explore, in this pilot study, the usefulness of OCT in imaging of the intracranial artery wall.

Methods Between November 2017 and July 2018, four patients with severe intracranial vertebrobasilar artery stenosis were enrolled for preintervention OCT evaluation of the lesion artery. Stenosis was present in the basilar artery in one case and in the intracranial vertebral artery in three cases.

Results OCT images of the lesions showed various features of plaque vulnerability, such as intraluminal thrombus, lipid-rich plaque with plaque rupture, thin fibrous cap, macrophage accumulations, and a mixed lesion with dissecting aneurysm. In view of the OCT findings, all patients received balloon angioplasty and stent implantation.

Conclusions These cases describe the successful implementation of OCT in intracranial vertebrobasilar artery stenosis. No side effects were seen during the OCT imaging. This technology may help in the diagnosis and treatment of cerebrovascular disease.

  • atherosclerosis
  • plaque
  • vessel wall

https://doi.org/10.1136/neurintsurg-2019-015660

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    Footnotes

    • XX and ML contributed equally.

    • Contributors XX and ML participated in the study design, collection, interpretation and analysis of data, writing of the manuscript. RL participated in the collection, interpretation and analysis of data, writing of the manuscript. QY participated in the collection, interpretation and analysis of data. XS, FW, JG, GX, and RY participated in analysis of data, writing and revising of the manuscript. XL participated in the study design, collection, interpretation and analysis of data, revising of the manuscript.

    • Funding National Natural Science Foundation of China (81530038, 81870946, 81901218); National Key Research and Development Program of China (2017YFC1307900); Jiangsu Science and Technology Project (BE2016748).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.