Introduction Here, we report our experience in using hydrophilic polymer-coated (HPC) Devices with prasugrel as single antiplatelet therapy (SAPT) to treat patients with subarachnoid hemorrhage (SAH) in the acute setting.

Aim of Study The objective of this study is to assess the safety and efficacy of HPC-coated devices with prasugrel as SAPT in the treatment of SAH patients.

Methods Patients treated within 30 days after SAH with a p64/p48 MW HPC FDs, pEGASUS or pCONUS 2-HPC (Wallaby Medical Phenox) were prospectively identified. Outcomes, intraprocedural and postprocedural complications, and mid-term follow-up were evaluated.

Results A total of 55 patients (51% women; mean age 52 years) were treated in 58 sessions using 78 devices (p64 MW HPC: 39; p48 MW HPC: 31; pEGASUS: 6; pCONUS 2-HPC: 2). Two patients (3,6%) experienced FD-dependent ischaemic complications. No intraprocedural thromboembolic complications were documented. No cases of aneurysm rerupture or hemorrhagic complications related to antiplatelet therapy were recorded. Three patients exhibited mild, non-haemodynamically relevant intimal hyperplasia in the mid-term control. No devices demonstrated in-stent stenosis or occlusion.

Conclusion The utilisation of HPC-coated devices with prasugrel as SAPT is both safe and efficacious in the treatment of patients with acutely ruptured aneurysms. It is essential to manage SAPT with prasugrel adequately, particularly through the utilisation of higher than usual doses and the performance of daily efficacy testing, in order to prevent the occurrence of ischaemic and thromboembolic complications.

Disclosure of Interest no.