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Background Stent-assisted coiling is widely used for the treatment of wide-necked intracranial aneurysms. The pEGASUS-HPC stent features a hydrophilic polymer coating designed to reduce thrombogenicity, potentially improving safety, particularly in ruptured aneurysms and complex configurations.Objective To evaluate the safety, efficacy, and technical feasibility of stent-assisted coiling using the pEGASUS-HPC stent in the treatment of wide-necked intracranial aneurysms.Methods We retrospectively analyzed 223 patients with 251 wide-necked aneurysms treated at six centers between July 2021 and March 2025. Primary endpoints included angiographic occlusion (modified Raymond–Roy classification, MRRC), periprocedural complications, and clinical outcome (modified Rankin Scale, mRS) at discharge and follow-up. Subgroup analysis was performed for ruptured aneurysms and bifurcation cases requiring Y-stenting.Results Stent deployment and coiling were technically successful in all cases. Immediate complete occlusion (MRRC I) was achieved in 92.4% of aneurysms, increasing to 96.8% at follow-up. The overall retreatment rate was 2.2%. Periprocedural complications occurred in 1.6% of cases, consisting of two minor perforations in unruptured aneurysms, both managed without clinical consequences. In ruptured cases a favorable outcome (mRS ≤2) was observed in 71.1%, with mortality confined to Hunt and Hess grade V or basilar artery aneurysms. Y-stenting was performed in 15.9% of cases without technical failure. No perforations occurred in ruptured cases.Conclusion Stent-assisted coiling with the pEGASUS-HPC stent appears technically feasible and effective for wide-necked aneurysms, including acute ruptured cases and those requiring Y-stenting, with high occlusion rates and low complication rates.