Abstract： Objective To investigate the impact of carotid artery stenting (CAS) combined with hyperbaric oxygen (HBO) on cerebral hemodynamics in patients with internal carotid artery stenosis.Methods Seventy-eight patients with severe unilateral carotid artery stenosis were randomly divided into the control group (n =36) and the experimental group (n =42),which all received carotid artery stenting.After surgery,the control group was treated with anti-platelet and other routine treatment,while the experimental group received HBO therapy within 24 hours after surgery,in addition to routine treatment.Trancranial Doppler (TCD) and Computed tomography perfusion (CTP) were used to detect changes in cerebral hemodynamics both before and after surgery,as well as 2 weeks after surgery,and the rate of stroke recurrence was also observed within one year of surgery.Results Mean velocity (Vm) of blood flow,peak systolic velocity (PSV),pulse index (PI) and cerebrovascular reserve (CVR) of the affected middle cerebral artery were significantly increased after surgery.Moreover,2 weeks after surgery,regional cerebral blood volume and flow (rCBV and rCBF) of the experimental group were also significantly higher,as compared with those before surgery (P ＜ 0.05).Mean transit time (rMTT) and peak time (rTTP) were all lower than those before surgery.Changes in rCBF,rMTT and rTTP 2 weeks after surgery were all greater than those of the control group(P ＜ 0.05).Oneyear follow-up indicated that stroke recurrence rate of the experimental group was lower than that of the control group (11.9％ vs.16.7％,P ＜ 0.05).Conclusions Carotid artery stenting combined with HBO intervention could improve cerebral hemodynamics in patients with severe internal carotid artery stenosis,and at the same time could reduce stroke recurrence rate.