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Purpose <p>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.</p> Methods <p>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.</p> Results <p>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&#xa0;h was 5 and the median ASPECTS was 8. At 24&#xa0;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 &lt; 2 at 90 days).</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年7月26日

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  • 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

摘要

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.