Introduction The Acandis Acclino Flex Plus (AFP) is a flexible, fourth-generation microstent designed to treat a wide range of aneurysms. It can be delivered through 0.017’ microcatheters with stent diameters up to 5.5 mm.

Aim of Study To present our single-center experience with the AFT in the treatment of complex aneurysms.

Methods The AFP was used in 28 patients with 28 aneurysms. A retrospective analysis was performed to evaluate aneurysm characteristics, technical success, complications, clinical outcomes and angiographic results.

Results The cohort included 8 untreated unruptured aneurysms, 9 recurrent unruptured aneurysms and 12 ruptured aneurysms (diameters: 3 – 23 mm). The most common location was the anterior communicating artery (52%). Successful stenting was achieved in 28 cases (97%), with an average of 1.3 stents per aneurysm. The overall procedural complication rate was 17%, including two major clinical events (6.8%, an ischaemic stroke and an aneurysm perforation) and one minor clinical event (3.4%, a seizure). Follow-up angiographic results for 23 aneurysms at an average of 6 months post-procedure showed complete occlusion in 74%, neck remnants in 13% and aneurysm remnants in 13%. Three patients required retreatment.

Conclusion The AFP stent demonstrated feasibility and favourable safety and efficacy in the treatment of complex aneurysms. These results support its clinical use and highlight the need for further studies to evaluate its performance in different aneurysm subsets and to determine its specific role in the endovascular treatment of aneurysms.

Disclosure of Interest CK serves as consultants for Acandis GmbH (Pforzheim, Germany) and proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA). David Zopfs is on the speaker’s bureau of Philips (Amsterdam, the Netherlands) and lecturer for Amboss GmbH (Cologne, Germany).