310 The Derivo 2 Heal Embolization Device in the Treatment of Ruptured and Unruptured Intracranial Aneurysms: A Retrospective Multicenter Analysis

INTRODUCTION: The Derivo 2 Flow diverter has been previously described for the treatment of intracranial aneurysms. To overcome the risk of in-stent thrombosis and thrombo-embolism as a well-known risk of intracranial flow diverter implantation, the device was modified by adding an antithrombogenic fibrin-heparin coating. The fibrin network aims at surface passivation, reduction of inflammatory reactions and building a scaffold for endothelial cells. The covalently bound heparin reduces the thrombogenicity by locally reducing platelet activation and inhibtion of the coagulation cascade. METHODS: We perform a retrospective multicenter, single-arm trial at seven neurovascular centers. Patients treated with the D2H for unruptured or ruptured intracranial aneurysms are included in the study. The primary endpoint is angiographic aneurysm occlusion at six months as assessed by the O’Kelly-Marotta (OKM) grading scale. Clinical outcome is evaluated after intervention and at six months with major morbidity defined as modified Rankin Scale scores (mRS) of 3-5. RESULTS: Between October 2021 and March 2023 56 patients with ruptured and unruptered intracranial aneurysms were treated with the D2H embolization device and included in our analysis. All patients were subjected to the regular antiplatelet pre- and post-treatment medication as per standard of care in the respective institutions with no deviations being reported. No differences in terms of technical device properties were observed. By the time of the conference, data evaluation will be completed and clinical as well as safety results including angiographic follow-up will be available. CONCLUSIONS: The Derivo 2 heal Flow Diverter is a promising antithrombogenic coated device for the treatment of ruptured and unruptured intracranial aneurysms. Early post-interventional and long-term results will provide further insight into the effect of antithrombogenicity and endothelial healing.