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Objectives <p>To compare the feasibility, efficiency, and safety of the pEGASUS-HPC stent pusher-assisted catheterization (PAC) technique between ruptured and unruptured wide-neck intracranial aneurysms treated with stent-assisted coiling.</p> Methods <p>Multicenter retrospective study (June 2021–June 2025) evaluating the pEGASUS-HPC PAC technique in ruptured and unruptured wide-neck intracranial aneurysms treated with stent-assisted coiling. A microwire-assisted catheterization (MAC) cohort was included as a reference cohort. Primary endpoints were catheterization success and catheterization time; safety endpoints included perforation, dissection, and vasospasm.</p> Results <p>A total of 151 patients with 186 aneurysms were analyzed, including a PAC cohort of 91 patients with 111 aneurysms (27 ruptured, 84 unruptured) and a MAC reference cohort of 60 patients with 75 unruptured aneurysms. Catheterization success was achieved in 26/27 ruptured aneurysms (96.3%) and 79/84 unruptured aneurysms (94.0%) (<i>p</i> = 0.637). Mean catheterization time was 44 ± 14&#xa0;s in ruptured aneurysms and 43 ± 21&#xa0;s in unruptured aneurysms (<i>p</i> = 0.78). No catheterization-related perforations or dissections occurred in either PAC group, and no major procedural complications were recorded. Compared with the MAC reference cohort (289 ± 78&#xa0;s), PAC was associated with significantly shorter catheterization times in both ruptured and unruptured aneurysms (both <i>p</i> &lt; 0.001) while maintaining high technical success rates.</p> Conclusion <p>The PAC technique demonstrated high catheterization success rates, short catheterization times, and a favorable safety profile in both ruptured and unruptured wide-neck intracranial aneurysms. Aneurysm rupture status did not significantly influence procedural performance or safety. Larger prospective studies are warranted to confirm these findings and further define patient- and anatomy-specific indications for the technique.</p>

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Comparison of pEGASUS-HPC stent pusher-assisted catheterization (PAC) in ruptured and unruptured wide-necked cerebral aneurysms: a multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月25日

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  • Mohammad Almohammad,
  • Ali Khanafer,
  • Mete Dadak,
  • Christopher Nimsky,
  • Zaid Samhan,
  • Bayan Alhaj Mouatafa,
  • Abdallah Aburub,
  • Mariana Gurschi,
  • Stephan Felber,
  • Zakarya Ali,
  • Hans Henkes,
  • André Kemmling

摘要

Objectives

To compare the feasibility, efficiency, and safety of the pEGASUS-HPC stent pusher-assisted catheterization (PAC) technique between ruptured and unruptured wide-neck intracranial aneurysms treated with stent-assisted coiling.

Methods

Multicenter retrospective study (June 2021–June 2025) evaluating the pEGASUS-HPC PAC technique in ruptured and unruptured wide-neck intracranial aneurysms treated with stent-assisted coiling. A microwire-assisted catheterization (MAC) cohort was included as a reference cohort. Primary endpoints were catheterization success and catheterization time; safety endpoints included perforation, dissection, and vasospasm.

Results

A total of 151 patients with 186 aneurysms were analyzed, including a PAC cohort of 91 patients with 111 aneurysms (27 ruptured, 84 unruptured) and a MAC reference cohort of 60 patients with 75 unruptured aneurysms. Catheterization success was achieved in 26/27 ruptured aneurysms (96.3%) and 79/84 unruptured aneurysms (94.0%) (p = 0.637). Mean catheterization time was 44 ± 14 s in ruptured aneurysms and 43 ± 21 s in unruptured aneurysms (p = 0.78). No catheterization-related perforations or dissections occurred in either PAC group, and no major procedural complications were recorded. Compared with the MAC reference cohort (289 ± 78 s), PAC was associated with significantly shorter catheterization times in both ruptured and unruptured aneurysms (both p < 0.001) while maintaining high technical success rates.

Conclusion

The PAC technique demonstrated high catheterization success rates, short catheterization times, and a favorable safety profile in both ruptured and unruptured wide-neck intracranial aneurysms. Aneurysm rupture status did not significantly influence procedural performance or safety. Larger prospective studies are warranted to confirm these findings and further define patient- and anatomy-specific indications for the technique.