{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T07:01:11Z","timestamp":1784962871485,"version":"3.55.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008967","name":"Philipps-Universit\u00e4t Marburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008967","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuroradiology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multicenter retrospective study (June 2021\u2013June 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.637). Mean catheterization time was 44\u2009\u00b1\u200914\u00a0s in ruptured aneurysms and 43\u2009\u00b1\u200921\u00a0s in unruptured aneurysms (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.78). 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\u2009\u00b1\u200978\u00a0s), PAC was associated with significantly shorter catheterization times in both ruptured and unruptured aneurysms (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) while maintaining high technical success rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-026-04121-6","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T06:18:50Z","timestamp":1784960330000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of pEGASUS-HPC stent pusher-assisted catheterization (PAC) in ruptured and unruptured wide-necked cerebral aneurysms: a multicenter study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4233-8048","authenticated-orcid":false,"given":"Mohammad","family":"Almohammad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Khanafer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mete","family":"Dadak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Nimsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Samhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayan","family":"Alhaj Mouatafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdallah","family":"Aburub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Gurschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Felber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakarya","family":"Ali","sequence":"additional","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"}]}],"member":"297","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"4121_CR1","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1227\/01.NEU.0000290890.62201.A9","volume":"61","author":"A Biondi","year":"2007","unstructured":"Biondi A, Janardhan V, Katz JM et al (2007) Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms: strategies in stent deployment and midterm follow-up. 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Nimsky: Consultant for Brainlab, GE BK Medical, and Zeiss, outside the submitted work. All other authors declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the local ethics committee (IRB: 24-180 RS). Informed consent was waived due to the completely anonymized nature of the data analysis.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}