Work

PANTHER: Prasugrel-based aneurysm treatment with non-identical telescoping with flow diversion with hydrophilic polymer coating for endovascular reconstruction in acute subarachnoid hemorrhage

Year: 2025

Type: article

Abstract: Purpose The objective of this study is to report the initial experience with the PANTHER technique for ruptured intracranial aneurysms and to provide a descriptive comparison with patients treated using a single flow diverter (FD) under prasugrel single antiplatelet therapy (SAPT). Methods A retrospective analysis was conducted on patients with subarachnoid hemorrhage due to ruptured wide-neck aneurysms. The PANTHER group ( n = 8) underwent reconstruction with non-identical telescoping hydrophilic polymer–coated (HPC) FDs under prasugrel SAPT. For the purpose of comparison, the outcomes of patients treated with a single HPC-coated FD ( n = 21) were reviewed. The data included complications, angiographic occlusion, and clinical outcomes. Results The PANTHER procedures were technically successful, without procedure-related hemorrhagic, ischemic, or thromboembolic complications. At early follow-up (median 5 months), complete occlusion was observed in all available PANTHER cases, whereas in the single FD group, 77.8% of assessable aneurysms showed complete occlusion. At long-term follow-up, complete occlusion was documented in both groups. Conclusion In this single-center series, the PANTHER technique was technically feasible and associated with high early occlusion rates and favorable clinical outcomes under prasugrel SAPT. A descriptive comparison with single FD treatment suggests a potential hemodynamic benefit of non-identical telescoping constructs. Larger prospective studies are warranted to validate these preliminary findings.

Source: Interventional Neuroradiology

DOI: 10.1177/15910199251389065