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目的:利用光学相干断层成像（OCT）评估颈动脉支架置入术后组织脱垂的特征，分析不同组织脱垂类型与临床特征、术前斑块形态的相关性，并随访支架内新生内膜增生（NIH）情况。方法:收集2018年7月至2019年12月于南京大学医学院附属金陵医院（东部战区总医院）神经内科行颈内动脉支架置入术和手术前后OCT评估的病例。通过OCT评估术前斑块特征与术后即刻组织脱垂性质。根据组织脱垂性质分成平滑组织脱垂（STP）和不规则和（或）伴有强衰减信号的组织脱垂（I/HTP）两类。分析I/HTP与临床特征、术前斑块特征间的相关性，并总结NIH情况。结果:共纳入29例患者，其中23例（79.3%）伴有组织脱垂，包括9例伴有I/HTP、14例伴有STP。相较STP病变，伴有I/HTP的病变更多为富脂斑块（7/9比2/14， P=0.007），且多伴有斑块破裂（7/9比4/14， P=0.036）。此外，伴有I/HTP病变的组织脱垂纵向总长度相较STP病变似乎更长，但差异无统计学意义［3.0（1.5，4.6）mm 比1.1（0.7，3.2）mm， Z=1.294， P=0.201］。共6例患者接受OCT随访，平均随访6.7个月，其中3例的I/HTP病变均发生重度异质型NIH（50.1%~61.8%），而1例的STP病变和2例的没有组织脱垂的病变仅有轻度NIH。 结论:I/HTP相较STP更常出现在具有较大脂质核心和（或）纤维帽破裂的病变中，提示两者形成机制及预后可能不同，需大样本研究进一步论证。

Objective:To assess the prevalence and type of tissue prolapse (TP) occurring after endovascular treatment (ET), investigate the association between TP types and plaque morphological characteristics before ET, and observe in-stent neointimal hyperplasia (NIH) using optical coherence tomography (OCT).Methods:Patients who underwent carotid artery stenting and received pre- and post-ET OCT assessment at Jinling Hospital between July 2018 and December 2019 were collected. Baseline plaque characteristics and TP features were evaluated using OCT. The TPs were classified into two categories: smooth TP (STP) and irregular and/or high attenuated TP (I/HTP). The association between I/HTP and plaque characteristics was analyzed, while NIH feature was also summarized.Results:A total of 29 patients were included in the study, of whom 23 patients (79.3%) presented with TP. Among these 23 patients, 9 were classified as I/HTP and 14 were classified as STP. Compared with STP, I/HTP was more commonly observed in lipid-rich plaques (7/9 vs 2/14, P=0.007), and lesions with cap rupture (7/9 vs 4/14, P=0.036). Additionally, the longitudinal length of TP appeared to be longer in cases with I/HTP compared to those with STP [3.0 (1.5, 4.6) mm vs 1.1 (0.7, 3.2) mm, Z=1.294, P=0.201]. Six patients underwent OCT follow-up for a mean duration of 6.7 months, of whom 3 patients with I/HTP showed severe heterogeneous NIH (50.1%-61.8%), while 1 patient with STP and 2 patients without TP only demonstrated mild NIH. Conclusions:The study observed that I/HTP was commonly found in plaques with larger lipid core and/or cap rupture, and suggested a potential relationship between I/HTP and NIH. These preliminary findings obtained from a limited sample should be verified by prospective large-scale studies.