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P058/65  Two-year follow-up of distal unruptured intracranial aneurysms treated with a surface-modified flow diverter under prasugrel monotherapy
  1. Luis Henrique Castro-Afonso1,
  2. João Paulo Machado1,
  3. Guilherme Nakiri1,
  4. Thiago Abud2,
  5. Lucas Monsignore3,
  6. Rafael Freitas3,
  7. Ricardo Oliveira4,
  8. Benedicto Colli4,
  9. Daniel Abud1
  1. 1University of São Paulo, Interventional Neuroradiology, Ribeirão Preto
  2. 2 Hospital Israelita Albert Einstein, Interventional Neuroradiology, São Paulo
  3. 3University of São Paulo, Ribeirão Preto
  4. 4University of São Paulo, Division of Neurosurgery, Ribeirão Preto


Introduction A new generation of modified surface FDs and monotherapy using new antiplatelets may reduce both ischemic and hemorrhagic complications during the treatment of intracranial aneurysms. Long-term outcomes of distal IA treated with FD under antiplatelet monotherapy are unknown.

Aim of Study The aim of the present pilot study was to assess the two-year follow-up safety and efficacy of p48 MW HPC in the treatment of unruptured distal IA under the use of prasugrel monotherapy during 6 months following by aspirin until 24 months.

Methods This was a single-center, prospective, pivotal, open, single-arm study. The primary (safety) endpoint was the absence of any new neurological symptoms after treatment until the 24-month follow-up. The primary (efficacy) endpoint was the incidence of complete aneurysm occlusion 24 months after treatment. The secondary (efficacy) endpoints were incidence of aneurysm dome reduction ≥ 50%, and incidence of aneurysm dome reduction < 50%, 24 months after treatment.

Results Twenty-one patients harboring 27 distal aneurysms of the anterior circulation were included. No patient had symptoms from treatment until 24-month follow-up. Complete aneurysm occlusion occurred in 20 (74%) of 27 aneurysms at the 24-month follow-up. Two aneurysms (7.4%) had a dome reduction ≥ 50%, 2 aneurysms (7.4%) had a dome reduction < 50%, and 3 aneurysms (11.1%) remained unchanged.

Conclusion In this pilot trial, the treatment of distal, unruptured intracranial aneurysms with a stent under monotherapy with prasugrel appeared to be safe and effective.

Disclosure of Interest Nothing to disclose

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