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New devices and techniques
Original research
The pEGASUS-HPC stent system for intracranial arterial stenosis: a single-center case series
  1. Daniel Pielenz1,
  2. Joachim Klisch1,2,
  3. David Fiorella3,
  4. Matthias Gawlitza4,
  5. Andreas Steinbrecher5,
  6. Elke Leinisch5,
  7. Elmar Lobsien5,
  8. Karl-Titus Hoffmann4,
  9. Donald Lobsien1
    1. 1Department of Neuroradiology, Helios Hospital Erfurt, Erfurt, Thüringen, Germany
    2. 2Department of Neuroradiology, Helios Vogtland Hospital Plauen, Plauen, Sachsen, Germany
    3. 3Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA
    4. 4University Hospital Leipzig Institute for Neuroradiology, Leipzig, Sachsen, Germany
    5. 5Department of Neurology, Helios Hospital Erfurt, Erfurt, Thüringen, Germany
    1. Correspondence to Daniel Pielenz, Neuroradiology, Helios Hospital Erfurt, Erfurt, Thüringen, Germany; daniel.pielenz{at}helios-gesundheit.de

    Abstract

    Background Intracranial arterial stenting is a technique for the treatment of symptomatic stenosis. 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 acute ischemic stroke and elective cases.

    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 and the mean±SD age was 71±10.8 years. 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. One stent-related hemorrhagic complication (subarachnoid hemorrhage) occurred in emergency cases and symptomatic intracerebral hemorrhage occurred in one 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±58.6 days, 62.5% of the 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.

    • stroke
    • stenosis
    • stent
    • angiography
    • atherosclerosis

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

    https://doi.org/10.1136/jnis-2024-021737

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      Data availability statement

      All data relevant to the study are included in the article or uploaded as supplementary information.

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      Footnotes

      • Contributors DP: guarantor, data collection, study design, data analysis, writing of the manuscript and revisions. JK: data collection, careful revision of the manuscript. ELe and ELo: careful revision of the manuscript, data collection. DF, AS, K-TH: careful revision of the manuscript. DL: data collection, study design, careful revision of the manuscript.

      • 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 DP: Phenox – travel expenses. 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. JK: Phenox travel expenses, speaker honoraria; Phenox, Microvention – consulting fees (money paid to institution). MG: Phenox – speaker honoraria, consulting fees; Microvention – speaker honoraria, consulting fees; Balt – consulting fees; Simq GmbH – Scientific advisory board member. AS, EL, EL: none. KT-H: Bayer – speaking honoraria, advisory fees. DL: Phenox – travel expenses, speaker honoraria (money paid to institution).

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