ORIGINAL RESEARCH article

Front. Neurol.

Sec. Endovascular and Interventional Neurology

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1605808

Use of p48 flow diverters with hydrophilic polymer coating under prasugrel single antiplatelet therapy for intracranial aneurysms arising from small-caliber vessels (≤ 2 mm): case series, complication, and occlusion rates

Provisionally accepted
Ali KhanaferAli Khanafer1*Pablo Albiña-PalmarolaPablo Albiña-Palmarola1Kamran HajiyevKamran Hajiyev1Philipp V. GottbergPhilipp V. Gottberg1Andrei FiliogloAndrei Filioglo2Michael ForstingMichael Forsting3Hans HenkesHans Henkes1,3
  • 1Klinik für Neuroradiologie, Klinikum Stuttgart, Stuttgart, Germany
  • 2Department of Neurosurgery, Institute of Emergency Care, Chisinau, Moldova
  • 3Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, North Rhine-Westphalia, Germany

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AbstractPurpose Flow-diverter (FD) stents have become an established treatment for intracranial aneurysms in recent years, but their use for aneurysms in distal cerebral vessels with small caliber remains controversial. This study reports our single-center experience in using hydrophilic polymer-coated (HPC) p48 MW FDs with prasugrel single antiplatelet therapy (SAPT) to treat ruptured and unruptured aneurysms arising from small-caliber vessels (≤ 2 mm).Methods A prospectively maintained database was retrospectively reviewed to identify all cases of intracranial aneurysms arising from small-caliber vessels (≤ 2 mm) treated with the p48 MW HPC device under SAPT (Prasugrel). The clinical presentation and outcomes, periprocedural and postprocedural complications, and degree of occlusion at follow-up (FU) were evaluated.Results A total of 62 patients (70.7% women) with 65 aneurysms were treated. Two patients (3.2%) experienced complications associated with FD use. No cases of aneurysm rupture or hemorrhagic complications associated with antiplatelet therapy or FD treatment were recorded. The rate of complete occlusion was 71.9% in the early FU period (3–6 months) and 86.1% in the initial 12-month period.Conclusion p48 MW HPC FDs with prasugrel SAPT showed high safety in the treatment of ruptured and unruptured aneurysms arising from small-caliber vessels (≤ 2 mm), and high occlusion rates at early- and mid-term FU.

Keywords: flow diversion, Aneurysm, small-caliber vessels, Single antiplatelet therapy, Coating & surface treatment

Received: 04 Apr 2025; Accepted: 03 Jun 2025.

Copyright: © 2025 Khanafer, Albiña-Palmarola, Hajiyev, V. Gottberg, Filioglo, Forsting and Henkes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ali Khanafer, Klinik für Neuroradiologie, Klinikum Stuttgart, Stuttgart, Germany

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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