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In hyperacute settings, stenting is constrained by the need for intensive antiplatelet therapy. This study evaluated the antithrombogenic hydrophilic polymer\u2013coated pEGASUS-HPC self-expanding stent for IADS-related AIS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study across seven stroke centers included consecutive patients with AIS and occlusion or severe flow-limiting stenosis caused by symptomatic IADS, who were treated with the pEGASUS-HPC. The outcomes were technical and angiographic success (device opening; mTICI score \u22652b when reperfusion was targeted), peri-procedural complications, mRS score, and follow-up patency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 36 treated patients (mean age 62.0\u2009\u00b1\u200919.6 years; 63.9% men), 91.7% of the dissections were spontaneous, and 80.6% were occlusive. Mechanical thrombectomy preceded stenting in 26\/29 occlusive cases. Full stent opening occurred in 94.4%, and 100% reperfusion success was achieved in targeted vessels. Most patients received periprocedural intravenous antiplatelet bridging (75.0%) and were discharged on DAPT (77.8%). Whereas no intraprocedural complications occurred, four postprocedural events occurred during admission (11.1%), of which two were clinically significant and two were minor and asymptomatic. The mean NIHSS score improved from 11.8 at admission to 4.9 at discharge, and the mean discharge mRS score was 2.1. Clinical follow-up (mRS) was available in 33\/36 patients (91.7%), with favorable functional outcome (mRS 0\u20132) in 27\/33 (81.8%). Imaging follow-up at the early window (mean 94 days) was available in 27\/36 (75.0%). In-stent stenosis\u2009\u2265\u200950% occurred in 14.8% and 4.2% of patients at early and mid-term follow-up, respectively, whereas no device occlusions or recurrent strokes occurred through mid-term follow-up. Long-term imaging follow-up (15\/36, 41.7%) showed no new in-stent stenosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>pEGASUS-HPC stenting for IADS-related AIS was technically feasible and achieved high reperfusion rates and a low overall complication burden, thus supporting prospective evaluation with standardized antiplatelet protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-026-04119-0","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:42:11Z","timestamp":1785404531000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antithrombogenic coated self-expanding stent (pEGASUS-HPC) for the treatment of intracranial dissections of the cerebral arteries in acute stroke: a multicenter study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2819-4623","authenticated-orcid":false,"given":"Abdallah","family":"Aburub","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Henkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Kemmling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Forsting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Lozupone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Pauciulo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Giuseppe Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Tortora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amedeo","family":"Cervo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guglielmo","family":"Pero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakarya","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Allaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"von Gottberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamran","family":"Hajiyev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Almohammad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Albi\u00f1a-Palermola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Akgoel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Kemmling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Filioglo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Khanafer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"issue":"6","key":"4119_CR1","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1016\/S1474-4422(15)00009-5","volume":"14","author":"S Debette","year":"2015","unstructured":"Debette S, Compter A, Labeyrie MA, Uyttenboogaart M, Metso TM, Majersik JJ et al (2015) Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection. 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World Neurosurg 76(6):S24\u201334. https:\/\/doi.org\/10.1016\/j.wneu.2011.02.031","journal-title":"World Neurosurg"}],"container-title":["Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00234-026-04119-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00234-026-04119-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00234-026-04119-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:04:08Z","timestamp":1785449048000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00234-026-04119-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":34,"alternative-id":["4119"],"URL":"https:\/\/doi.org\/10.1007\/s00234-026-04119-0","relation":{},"ISSN":["0028-3940","1432-1920"],"issn-type":[{"value":"0028-3940","type":"print"},{"value":"1432-1920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]},"assertion":[{"value":"4 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This retrospective study was conducted in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki Declaration and its later amendments. Ethical approval was obtained from the responsible ethics committees of the participating institutions (reference Nos. 25\u2013213 RS and F-2018-080).","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Because of the retrospective design, the requirement for informed consent was waived by the ethics committees.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable (no identifiable patient data are presented).","order":3,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"H. Henkes: consulting and proctoring for WallabyPhenox GmbH, co-owner of CONTARA GmbH. A. Kemmling: consulting and proctoring for WallabyPhenox GmbHA. Khanafer: consulting and proctoring for WallabyPhenox GmbH. The authors declare that they have no further potential conflicts of interest.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}