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Introduction The introduction of stent-assisted coiling has revolutionized the treatment of wide intracranial aneurysms (IA). Since their introduction into clinical practice, many technical advancements have been made in terms of enhanced deliverability, low-profile designs and reduced surface thrombogenicity.Aim of study The aim of this study was to assess the real-world feasibility, safety, and efficacy of the pEGASUS-HPC device in the treatment of intracranial aneurysms.Method This independent, multicenter, retrospective observational study evaluated the outcomes of patients treated with the stent-assisted coiling technique using the pEGASUS HPC device between april 2022 and december 2024. An analysis of the procedures, complications (both clinical and technical) and imaging follow-up was conducted to assess the device’s feasibility, safety, and efficacy.Results A total of 99 aneurysm (30 ruptured and 69 unruptured) were treated in 98 patients (58 females and 40 males) using 130 pEGASUS HPC stents. The successful deployment rate was 97%. The overall device-related mortality and morbidity rate was 2%. Adequate occlusion (Raymond-Roy class I-II) at the end of the procedure was achieved in 94% of cases. At follow-up (median time 239.8 days), adequate occlusion was obtained in 93% of the screened cases.Conclusion The use of the pEGASUS HPC device in the treatment of intracranial aneurysms is highly feasible, safe, and effective, although further data are needed to assess the impact of the surface coating on safety in both emergency and elective procedures.Conflict of Interest No