Real-world use of the pEGASUS-HPC stent in cerebral aneurysms: results from a multicenter retrospective series

Stent-assisted coiling has revolutionized the treatment of wide-neck intracranial aneurysms. Several technical improvements have since emerged, including enhanced deliverability, low-profile designs, and reduced surface thrombogenicity. This study aimed to assess the real-world feasibility, safety, and efficacy of the pEGASUS-HPC device for intracranial aneurysms.

This independent, multicenter, retrospective observational study evaluated patients treated with pEGASUS-HPC stent-assisted coiling between April 2022 and December 2024. Data on procedural outcomes, complications (technical and clinical), and imaging follow-up were analyzed.

Ninety-nine aneurysms (30 ruptured (30.3%), 69 unruptured (69.7%)) in 98 patients (58 female (59.2%), 40 male (40.8%) were treated using 130 pEGASUS-HPC stents. The successful deployment rate was 97%. Device-related mortality and morbidity were 2% and 1%, respectively. Ischemic complication rates did not significantly differ between acute and elective cases or between single and dual antiplatelet therapy groups. Adequate occlusion (Raymond-Roy Class I-II) was achieved in 95% immediately post-procedure and 93% at follow-up (median 240 days).

The pEGASUS-HPC stent shows high feasibility, safety, and effectiveness in the treatment of intracranial aneurysms. Further research is warranted to assess the impact of its surface coating, especially in emergency settings.