Y-stent-assisted coiling with pEGASUS stents for intracranial bifurcation aneurysms: A multi-center retrospective...

ObjectivesY-stent-assisted coiling (Y-SAC) is an established technique for managing wide-necked intracranial bifurcation aneurysms. However, data on the use of the pEGASUS stent, a self-expanding open-cell stent with an antithrombogenic hydrophilic polymer coating, remain limited. This study evaluated the effectiveness and safety of Y-SAC with pEGASUS stents in patients with intracranial bifurcation aneurysms.MethodsThis retrospective observational study included patients treated with Y-SAC with pEGASUS stents at six neurovascular centers between July 2021 and June 2024. Data on aneurysm characteristics, procedural details, and clinical outcomes were collected. Aneurysm occlusion was assessed with the modified Raymond-Roy classification (MRRC) at 6 and 12 months. The primary endpoint was complete aneurysm occlusion (MRRC I), whereas secondary endpoints included perioperative complications, functional outcomes, and retreatment rates.ResultsA total of 40 patients (mean age: 61.6 ± 9.4 years; 60% women) were included. Immediately post-procedure, 100% of aneurysms achieved complete occlusion (MRRC I). At 6-12 months follow-up, 92.5% maintained MRRC I occlusion, and 2.5% exhibited neck remnants (MRRC II). Functional outcomes were favorable in 95% of patients at discharge. The overall complication rate was 4.8%, and one patient (2.5%) required retreatment. No periprocedural thromboembolic events were observed.ConclusionsOur findings indicated that Y-SAC with pEGASUS stents achieves high rates of durable aneurysm occlusion with minimal complications, thus supporting its use as a safe and effective strategy for wide-necked bifurcation aneurysms. Future prospective studies are needed to validate long-term outcomes and optimize treatment strategies.