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pEGASUS-HPC stent pusher assisted catheterization (PAC) technique in Y-stent-assisted coiling of unruptured
Mohammad Almohammad1,2, Bayan Alhaj Moustafa3,4, Ali Khanafer5
1Department of Neuroradiology, Philipps University of Marburg, Marburg, Germany. mohammad.almohammad1988@outlook.com.
Objectives:
To evaluate the safety and feasibility of the pusher-assisted catheterization (PAC) technique using the pEGASUS-HPC stent pusher instead of a microwire for accessing unruptured wide-necked cerebral aneurysms during Y-stent-assisted coiling.
Methods:
In this multicenter retrospective study (July 2021- June 2025), 48 unruptured wide-necked cerebral aneurysms underwent Y-stent-assisted coiling using pEGASUS HPC stents. Based on the catheterization technique, cases were assigned to either the microwire-assisted catheterization (MAC, n = 23) or the stent pusher-assisted catheterization (PAC, n = 25) group. Clinical and procedural data were analyzed to compare safety and efficacy, focusing on success rates, required catheterization time, complications, and adverse events.
Results:
The cohort had a mean age of 62.6 ± 9.8 years, with 64.3% of patients being female. In the MAC group, aneurysm catheterization was successful in all 23 cases (100%), with a mean catheterization time of 5.31 ± 1.2 min. In contrast, the PAC group achieved successful catheterization in 88% of cases (22/25), with a markedly reduced mean catheterization time of 0.82 ± 0.27 min-approximately 6.5 times faster than the conventional MAC technique (p < 0.001). Importantly, no procedure-related complications, such as perforations or dissections, were observed in either group.
Conclusion:
In this multicenter retrospective feasibility and safety analysis, PAC appeared to enable faster aneurysm access during Y-stent-assisted coiling without an increase in intraprocedural complications. As clinical outcomes were not assessed, these findings should be regarded as technical proof-of-concept and require confirmation in prospective, outcome-driven studies.
