Introduction Intracranial arterial stenting is a technique for treatment of symptomatic stenosis causing acute and/or recurrent ischemic stroke. In this single-center retrospective case series we evaluated a novel low profile laser-cut stent with an antithrombogenic hydrophilic polymer coating (pEGASUS- HPC, Phenox GmbH, Bochum, Germany) for the treatment of intracranial stenosis in the setting of thrombectomy and elective cases.

Aim of Study To evaluate whether bail-out and elective stenting using this stent is effective and save.

Methods All patients treated with pEGASUS-HPC for one or more intracranial arterial stenoses at our institution were retrospectively included. Clinical, imaging and procedural parameters as well as clinical and imaging follow-up data were collected.

Results We performed 43 interventions in 41 patients with 42 stenoses in our neurovascular center between August 2021 and February 2024. Twenty-one patients (51.2%) were female. Mean age was 71 years (+-10.8). Thirty-seven (86.1%) procedures were performed in the setting of endovascular acute ischemic stroke treatment. Technical or procedural complications occurred in seven patients (16.3%), six in the thrombectomy-group and one in the elective group. Two stent-related hemorrhagic complications in emergency cases (one SAH, one abdominal bleeding) were observed; one symptomatic intracerebral hemorrhage (sICH) occurred in a patient treated in an elective setting. Overall stenosis-reduction following pEGASUS-HPC stent-implantation was 53.0% (+-18.0). On follow up imaging, which was available for 16 patients (37.2%) after an average of 32 days (+-58.6), 62.5% of these stents were patent.

Conclusion Our single-center case series demonstrates the feasibility of using the pEGASUS-HPC stent system especially in emergency situations when thrombectomy fails.

Disclosure of Interest yes Daniel Pielenz: Phenox - travel expenses. David Fiorella: Medtronic, Cerenovous, Microvention, Penumbra, Stryker, Balt USA, Seimens, Mentice, Neurogami, Rapid.AI, Rapid Medical, Q’apel Medical, Arsenal Medical, Phenox, Scientia, NVMed, Perfuze, Vesalio – Consulting fees; Medtronic, Cerenovous, Microvention, Penumbra, Stryker, Balt USA, Q’apel Medical – Speaker honoraria; Medtronic, Cerenovous, Microvention, Penumbra, Stryker, Balt USA, Seimens, Mentice, Neurogami, Rapid.AI, Rapid Medical, Q’apel Medical, Arsenal Medical, Phenox, Scientia, NVMed, Perfuze, Vesalio – Travel expenses; Scientia, MENTICE, Neurogami, NVMed, Perfuze – Leadership role; Scientia, Perfuze, NVMED, Mentice, Neurogami – Stock options. Joachim Klisch: Phenox - travel expenses, speaker honoraria; Phenox, Microvention - Consulting fees (money paid to institution). Matthias Gawlitza: Phenox – speaker honoraria, consulting fees; Microvention – speaker honoraria, consulting fees; Balt – consulting fees; Simq GmbH – Scientific advisory board member. Andreas Steinbrecher, Elmar Lobsien, Elke Leinisch: none. Karl-Titus Hoffmann: Bayer – speaking honoraria, advisory fees. Donald Lobsien: Phenox - travel expenses, speaker honoraria (money paid to institution).