Introduction We report our initial experience with endovascular embolization of intracranial aneurysms using this new self-expanding open-cell stent system (pEGASUS stent system) with the antithrombogenic hydrophilic polymer coating.

Aim of Study We present our initial clinical experience with this novel stent system and compare available data of other intracranial stent systems.

Methods We retrospectively reviewed all patients treated with stent-assisted embolization using the pEGASUS stent system between September 2022 and June 2023. Demographic, clinical, and angiographic data were analyzed as well as short-term follow-up, including procedural complication rates and aneurysmal occlusion rates.

Results Twelve patients with 12 wide-necked intracranial aneurysms were treated with the pEGASUS stent system, including 2 acutely ruptured aneurysms embolized in an emergency setting. All stents were deployed successfully. Immediate complete aneurysmal occlusion (RROC class I) was achieved in 83.3% (10/12) and near-complete occlusion (RROC II) in 16.7% (2/12). No periprocedural complications occurred in patients treated in the elective setting. A single case of intraoperative in-stent thrombus formation occurred during the treatment of an acutely ruptured basilar aneurysm and was resolved with intravenous Tirofiban. No other periprocedural complications occurred. Eleven out of 12 patients were available for follow up (mean 7.4 months). Complete aneurysmal occlusion without in-stent stenosis (ISS) was seen in 10 patients (90.9%). One patient (9.1%) showed aneurysmal reperfusion (RROC IIIb) with asymptomatic moderate ISS.

Conclusion Our initial results demonstrate that the pEGASUS stent system appears to be a safe and effective device for stent assisted embolization of wide-necked intracranial aneurysms. More data is necessary to evaluate long-term follow-up.

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Abstract P087 Figure 1

Middle aged patient with an unruptured wide-necked BA aneurysm at the left SUCA origin in frontal oblique DSA (A) and 3D-angiography (B) via the right VA. Successful placement of the pEGASUS stent from the P2 segment of the left PCA into the basilar artery (black arrows in C and D indicate the proximal and distal stent markers). Stable complete occlusion of the aneurysm (RROC I) without in-stent stenosis in DSA follow-up after 10 months (D)

Disclosure of Interest yes Frederik Boxberg has recieved travel expenses from Medtronic (Dublin, Ireland) and research grant from Acandis (Pforzheim, Germany). Katharina Schulz has recieved travel expenses from Medtronic (Dublin, Ireland) and research grant from Acandis (Pforzheim, Germany). Dominik Grieb has recieved travel expenses from Medtronic (Dublin, Ireland) and Stryker (Kalamazoo, Michigan, USA) and speaker hono- raria from Medtronic (Dublin, Ireland). We declare no conflicts of interest or funds related to this study.