Objectives We aimed to investigate the association between the characteristics of tissue protrusion (TP) assessed by optical frequency domain imaging (OFDI) and brain lesions identified by diffusion-weighted imaging (DWI) after carotid artery stenting (CAS).
Background TP between stent struts is frequently observed on OFDI evaluation after CAS but its clinical relevance is unclear.
Methods Sixty five consecutive patients that underwent OFDI after protected CAS were enrolled in the study. Cross-sectional OFDI images within the stented segments were evaluated at 0.125-mm intervals. Magnetic resonance imaging (MRI) was performed 1 to 10 days after treatment. The characteristics of TP were compared between patients with (DWI+) and without (DWI–) new ipsilateral DWI lesions on the post-treatment MRI.
Results TPs were observed in 62 patients (95%). New DWI lesions were observed in 24 patients 37%). In the univariate analysis, the presence of protrusion with attenuation (odds ratio [OR], 2.89; 95% confidence interval [CI], 1.04-8.46; p = 0.04) was an associating factor of new DWI lesions after CAS.
Conclusions The presence of protrusion with attenuation assessed by OFDI was associated with ischemic brain lesions identified by DWI-MRI after CAS.

TISSUE PROTRUSION WITH ATTENUATION ASSESSED BY OPTICAL FREQUENCY DOMAIN IMAGING WAS ASSOCIATED WITH ISCHEMIC BRAIN LESIONS IN THE CAROTID ARTERY STENTING