P058/65 Two-year follow-up of distal unruptured intracranial aneurysms treated with a surface-modified flow diverter under prasugrel monotherapy

Introduction A new generation of modified surface FDs and monotherapy using new antiplatelets may reduce both ischemic and hemorrhagic complications during the treatment of intracranial aneurysms. Long-term outcomes of distal IA treated with FD under antiplatelet monotherapy are unknown. Aim of Study The aim of the present pilot study was to assess the two-year follow-up safety and efficacy of p48 MW HPC in the treatment of unruptured distal IA under the use of prasugrel monotherapy during 6 months following by aspirin until 24 months. Methods This was a single-center, prospective, pivotal, open, single-arm study. The primary (safety) endpoint was the absence of any new neurological symptoms after treatment until the 24-month follow-up. The primary (efficacy) endpoint was the incidence of complete aneurysm occlusion 24 months after treatment. The secondary (efficacy) endpoints were incidence of aneurysm dome reduction ≥ 50%, and incidence of aneurysm dome reduction < 50%, 24 months after treatment. Results Twenty-one patients harboring 27 distal aneurysms of the anterior circulation were included. No patient had symptoms from treatment until 24-month follow-up. Complete aneurysm occlusion occurred in 20 (74%) of 27 aneurysms at the 24-month follow-up. Two aneurysms (7.4%) had a dome reduction ≥ 50%, 2 aneurysms (7.4%) had a dome reduction < 50%, and 3 aneurysms (11.1%) remained unchanged. Conclusion In this pilot trial, the treatment of distal, unruptured intracranial aneurysms with a stent under monotherapy with prasugrel appeared to be safe and effective. Disclosure of Interest Nothing to disclose