Abstract:Objective To investigate the relationship between carotid artery intima-media thickness（IMT） and stroke risk after transient ischemic attack（TIA） in internal carotid artery. Methods A total of 128 patients with internal carotid artery TIA treated in the Third Peoples Hospital of Bengbu from January 2019 to September 2021 were selected and divided into the stroke group（n=37） and the non-stroke group（n=91）. The patients were divided into high-risk group(n=21), medium risk group(n＝62) and low-risk group(n=45) according to ABCD2 score. The general data of all patients were collected, and the blood-lipid level, carotid artery IMT and the formation of plaque（shape, size and nature） were measured and observed. Multivariate logistic regression analysis was used to analyze the independent risk factors of stroke after TIA. Results The IMT value and the incidence of carotid soft plague and vulnerable plaque on the opposite side of symptoms in stroke group were significantly higher than those in non-stroke group（P＜0.01,P＜0.05）. The iucidences of carotid IMT and vulnerable plaque on the opposite side of symptoms in high-risk group and medium-risk group were significantly higher than those in low-risk group（P＜0.01）. The incidence of soft plaque in high-risk group was higher than that in medium and low-risk groups（P＜0.01）, while the incidence of mixed plaque in medium-risk group was higher than that in low-risk group（P＜0.01）. Multivariate logistic regression analysis showed that hypertension, time from first attack to visit, duration of symptoms, history of previous cerebral infarction and incidence carotid IMT on the opposite side of symptoms were the independent risk factors for stroke after internal carotid artery TIA(P＜0.05,P＜0.01). Conclusion TIA patients have a higher incidence of stroke, which is closely related to IMT thickening. Carotid artery IMT may also be an independent risk factor for stroke progression in patients with TIA of internal carotid artery system.