The Use of the P48 MW HPC® Flow Diverter in Parent Arteries Smaller than 2.0 mm in Diameter for the Treatment of Distal Intracranial Aneurysms.

• Grant number: 25/01300-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2025
• End date: March 31, 2026
• Field of knowledge: Health Sciences - Medicine - Medical Radiology
• Principal Investigator: Daniel Giansante Abud
• Grantee: Pedro Lucas Moreira Fernandes
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Intracranial aneurysms are vascular dilations that can occur in any territory of the cerebral circulatory system and represent a significant health risk, since they can rupture and cause subarachnoid hemorrhage (SAH), an event with high morbidity and mortality. Non-ruptured aneurysms can manifest clinically due to the mass effect on adjacent neurological structures or can be an incidental finding on imaging tests. Historically, the approach to these aneurysms has been challenging, mainly due to the limitations of traditional techniques - such as neurosurgical clipping - which present a higher risk of complications. However, recently, new devices have been created called flow diverters (FDs), which are stents placed in the artery at the level of the aneurysm neck in order to cause its occlusion by interrupting the intra-aneurysmal flow, while also offering support for the formation of a neointima. FDs have been able to overcome the difficulties imposed by traditional techniques, making them a viable and effective technique for non-ruptured aneurysms with complex anatomy (e.g. large neck and bifurcation with side branches) and for aneurysms that are difficult to access. In this scenario, the p48 flow modulation device (p48 MW, Phenox, Germany) has been widely used in Europe and has shown optimistic results, especially in small caliber vessels. However, there is currently no description in the literature of the use of the promising p48 device in vessels with a caliber of less than 2.0 mm. This project aims to prove the safety and efficacy of p48 in these vessels by carrying out a prospective study with clinical evaluation and angiography 6 and 12 months after treatment.