Pegasus stent as a rescue therapy in large vessel occlusions with underlying intracranial atherosclerosis: a retrospective Single-Center experience.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-07-26 DOI:10.1007/s00234-025-03724-9

Daniele Giuseppe Romano, Raffaele Tortora, Maria Di Gregorio, Alfredo Siani, Gianpiero Locatelli, Gianmarco Flora, Salvatore Tartaglione, Miriam Caterino, Giulia Pacella, Antonio Romanelli, Aniello Iovino, Paolo Barone, Giulia Frauenfelder

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引用次数: 0

Abstract

Purpose: Large vessel occlusions (LVOs) due to underlying intracranial atherosclerotic disease (ICAD) are associated with higher rates of mechanical thrombectomy (MT) failure and worse clinical outcomes. The pEGASUS-HPC stent is a novel low-profile device with a hydrophilic polymer coating designed to reduce thrombogenicity. Evidence regarding its use in ICAD-related LVOs is currently limited.

Methods: We conducted a retrospective single-center study to evaluate the safety and efficacy of the pEGASUS-HPC stent as a rescue treatment following MT failure in ICAD-related LVOs.

Results: From December 2022 to December 2024 among 393 thrombectomies performed, 25 patients met the inclusion criteria. The mean age was 66 years (53-90) and 18/25 (72%) were men. The anterior circulation was involved in most cases (17/25, 68%). Median baseline NIHSS was 8 and ASPECTS was 9. Rescue stenting was performed due to persistent occlusion (28%), residual stenosis (56%), or early reocclusion (16%). Final TICI 2b-3 recanalization was achieved in 92% of cases. Pre-stenting angioplasty was performed in 32% and post-stenting in 16% of cases. Periprocedural complications occurred in 16% of patients. Median NIHSS at 24 h was 5 and the median ASPECTS was 8. At 24 h, only 1/25 patients demonstrate in-stent thrombosis. Long-term follow-up (6 months) was available for 76% of patients; stent patency was maintained in all, and 84% achieved a favorable outcome (mRS < 2 at 90 days).

Conclusion: Rescue stenting with the pEGASUS-HPC stent in selected cases of ICAD-related LVO appears to be a feasible and effective treatment option after MT failure, with high recanalization rates, favorable clinical outcomes, and acceptable complication rates.

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Pegasus支架作为大血管闭塞伴颅内动脉粥样硬化的抢救治疗：一项回顾性单中心研究。

目的：颅内动脉粥样硬化性疾病（ICAD）引起的大血管闭塞（LVOs）与机械取栓（MT）失败率较高和临床结果较差相关。pEGASUS-HPC支架是一种新型的低轮廓装置，具有亲水聚合物涂层，旨在降低血栓形成性。关于其在icad相关的lvo中使用的证据目前有限。方法：我们进行了一项回顾性单中心研究，以评估pEGASUS-HPC支架作为icad相关lvo MT失败后的抢救治疗的安全性和有效性。结果：从2022年12月至2024年12月，在393例血栓切除术中，25例患者符合纳入标准。平均年龄为66岁（53-90岁），男性18/25（72%）。大多数病例累及前循环（17/25,68%）。基线NIHSS中位数为8，ASPECTS为9。由于持续咬合（28%），残留狭窄（56%）或早期再咬合（16%），进行了紧急支架置入。92%的病例最终实现了TICI 2b-3再通。支架置入术前血管成形术占32%，支架置入术后血管成形术占16%。16%的患者出现围手术期并发症。24 h时NIHSS中位数为5，ASPECTS中位数为8。24小时时，只有1/25的患者出现支架内血栓形成。76%的患者有长期随访（6个月）；结论：pEGASUS-HPC支架在部分icad相关LVO病例中是MT失败后可行有效的治疗选择，其再通率高，临床结果良好，并发症发生率可接受。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.