Article Text

Download PDFPDF
Original research
The pEGASUS-HPC stent system for stent-assisted coiling of cerebral aneurysms: a multicenter case series
  1. Donald Lobsien1,
  2. Markus Holtmannspoetter2,
  3. Florian Eff2,
  4. Ansgar Berlis3,
  5. Christoph Johannes Maurer3,
  6. Daniel Behme4,
  7. Elie Diamandis4,
  8. Matthias Gawlitza5,
  9. David Fiorella6,
  10. Ciro Princiotta7,
  11. Luigi Cirillo7,8,
  12. Massimo Dall'Olio7,
  13. Peter Keston9,
  14. Joachim Klisch1,
  15. Alberto Nania9
  1. 1Clinic of Neuroradiology, HELIOS Klinikum Erfurt, Erfurt, Germany
  2. 2Interventional and Diagnostic Neuroradiology, Nuremberg Hospital Campus South, Nuremberg, Germany
  3. 3Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
  4. 4Department of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany
  5. 5Institute of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
  6. 6Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA
  7. 7Neuroradiology Department, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
  8. 8Department of Experimental Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
  9. 9Department of Clinical Neurosciences, NHS Lothian, Edinburgh, UK
  1. Correspondence to Dr Donald Lobsien, Clinic of Neuroradiology, HELIOS Klinikum Erfurt, Erfurt 99089, Germany; donald.lobsien{at}gmail.com

Abstract

Background Stent-assisted coiling (SAC) is a well-established method for treatment of wide-necked intracranial aneurysms. In this multicenter, retrospective case series we evaluated SAC with a new low-profile, laser-cut stent with an antithrombogenic hydrophilic polymer coating (pEGASUS-HPC) for the treatment of intracranial aneurysms.

Methods Patients treated with pEGASUS-HPC SAC for one or more intracranial aneurysms were retrospectively included. Clinical, imaging, and procedural parameters as well as clinical and imaging follow-up data were recorded.

Results We treated 53 aneurysms in 52 patients in six neurovascular centers between August 2021 and November 2022. Thirty-seven patients (69.8%) were female. Mean age was 57 (±11.7) years. Twenty-nine patients were treated electively, 23 in the acute phase (22 with aneurysmal subarachnoid hemorrhage (SAH), and 1 with a partially thrombosed aneurysm causing ischemic events). One intraprocedural thromboembolic event and three postprocedural ischemic complications occurred in two (8.7 %) of the SAH patients and in one of the elective patients (3.45%). Overall aneurysm occlusion was Raymond Roy (RR) I in 36 (69.2%), RR II in 9, and RR III in 9 cases. Follow-up imaging was available for 23 patients after an average of 147.7 (±59.6) days demonstrating RR I occlusion in 22 (95.5%) and RR II in 1 patient.

Conclusion SAC with the pEGASUS-HPC stent system demonstrates rates of periprocedural safety and effectiveness that are comparable with previously reported series for stent-assisted coil embolization.

  • Aneurysm
  • Coil
  • Stent

Data availability statement

No data are available.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

No data are available.

View Full Text

Footnotes

  • JK and AN contributed equally.

  • Contributors DL: data collection, study design, data analysis, writing of the manuscript and revisions, center coordination. MH, FE, AB, CJM, DB, ED, CP, LC, MD, PK, AN: data collection, revision of the manuscript. DF, MG: revision of the manuscript. JK: data collection, study design, revision of the manuscript. JK and AN contributed equally to this work. DL is the study guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests All authors: phenox GmbH organized online meetings of the centers during the initiation of the work. DL: phenox – travel expenses, speaker honoraria (money paid to institution). MH: Balt, Medtronic, Microvention, Cerenovus, Stryker, Rapid Medical, phenox – consulting fees; Penumbra – speaker honoraria; Medtronic – steering committee “Inspire” Study. FE: did not disclose competing interests. AB: none. CJM: none. DB: phenox, Acandis, Stryker, Vesalio – consulting fees; Acandis – speaker honoraria; Acandis – travel expenses. ED: none. DF: 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. MG: phenox, Microvention, Balt – consulting; phenox – speaker honoraria. CP: none. LC: none. MD: none. PK: Medtronic, Stryker, Microvention – consulting fees; Stryker, Oxford Heartbeat – grants. JK: phenox – travel expenses, speaker honoraria; phenox, Microvention – consulting fees (money paid to institution). AN: none.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.