Early experience with the Surpass Elite flow diverter for unruptured intracranial aneurysms

The Surpass Elite (Stryker Neurovascular) is the latest generation of the Surpass flow diverter (FD) platform, featuring a higher braid angle consistently exceeding 150°, the BioStealth surface modification, and an expanded size matrix. We report our early single-center experience with the Surpass Elite in the treatment of intracranial aneurysms.

Retrospective analysis of a prospectively maintained database including 21 consecutive patients with 22 intracranial aneurysms treated with the Surpass Elite between March 2025 and January 2026 at a single high-volume neurointerventional center. We recorded and analyzed device deployment characteristics and imaging and clinical follow-up, as well as intraprocedural, early (< 30 days), and delayed (> 30 days) neurological complications.

Twenty-one patients (16 women, mean age 47 years) were treated for 22 aneurysms (3 previously ruptured, all saccular). Twenty-four devices were successfully deployed (mean of 1.1 devices per patient), with a 100% technical success rate. Five procedures (23.8%) were performed via radial access. No intraprocedural, early, or delayed neurological complications were observed. No intracranial hemorrhage or mortality occurred. All patients maintained a modified Rankin Scale score of 0 throughout follow-up. Imaging follow-up, available in 19/22 (86.4%) aneurysms (median 5 months), demonstrated complete occlusion (OKM grade D) in 12/19 (63.2%) and adequate occlusion (OKM grades C-D) < in 16/19 (84.2%).

Within the limits of a small single-center cohort and short imaging follow-up, our early experience with the Surpass Elite suggests favorable technical performance, an encouraging safety profile, and early occlusion rates consistent with previously reported flow diverters. Larger multicenter prospective studies with imaging follow-up extended to 12-24 months are warranted to confirm these preliminary findings.