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However, their impact on in-stent stenosis and aneurysm occlusion remains uncertain. We compared a\u00a0coated flow diverter (Derivo\u00a02 heal) with the corresponding uncoated device (Derivo\u00a02) regarding in-stent stenosis development and aneurysm occlusion in a\u00a0randomized clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      In this single-center randomized, open-label trial, 21\u00a0patients with unruptured internal carotid artery aneurysms were treated with either a\u00a0coated (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200910) or uncoated (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200911) flow diverter. All patients received dual antiplatelet therapy and underwent digital subtraction angiography at 3\u00a0and 9\u00a0months. In-stent stenosis was assessed using a\u00a0standardized ratio-based method. Device characteristics and oversizing were recorded. The presumed etiology of in-stent stenosis was categorized as intimal hyperplasia or stent deformity based on morphologic appearance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean in-stent stenosis at 3\u00a0and 9\u00a0months did not differ between groups. Complete aneurysm occlusion at 9\u00a0months was lower in the coated group (40.0% vs 81.8%; two-sided Fisher\u2019s exact\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.080). Oversizing was not associated with in-stent stenosis but was numerically greater in patients with complete occlusion. Stent deformity was associated with higher in-stent stenosis than presumed intimal hyperplasia (3\u00a0months: 40.8% vs 21.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.007; 9\u00a0months: 30.1% vs 13.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this randomized single-center study, the surface-modified Derivo\u00a02\u00a0heal did not demonstrate reduced in-stent stenosis compared with the uncoated Derivo\u00a02, while complete occlusion at 9\u00a0months was lower in the coated-device group. These findings warrant confirmation in larger comparative studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00062-026-01676-y","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:17:50Z","timestamp":1780679870000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["In-Stent Stenosis After Surface-Modified Versus Uncoated Flow Diversion: a\u00a0Randomized Trial (Derivo\u00a02 Heal vs Derivo\u00a02)"],"prefix":"10.1007","author":[{"given":"Malvina","family":"Garner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Fries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena","family":"Haussmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Reith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umut","family":"Yilmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"issue":"8","key":"1676_CR1","doi-asserted-by":"publisher","first-page":"2346","DOI":"10.1161\/STROKEAHA.106.479576","volume":"38","author":"DF Kallmes","year":"2007","unstructured":"Kallmes\u00a0DF, Ding\u00a0YH, Dai\u00a0D, Kadirvel\u00a0R, Lewis\u00a0DA, Cloft\u00a0HJ. 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