Could Statin Use Be Associated with Reduced Recurrence Rates following Coiling in Ruptured Intracranial Aneurysms?
OBJECTIVE
A number of studies have examined the role of matrix metalloproteinases in aneurysm healing following endovascular coiling. Because ruptured aneurysms are known to express higher levels of matrix metalloproteinases, we hypothesized that patients with subarachnoid hemorrhage who were on a statin at the time of coil embolization would have lower aneurysm recanalization and retreatment rates than patients not on statins.


METHODS
We performed a retrospective chart review of patients who underwent intrasaccular coil embolization of ruptured intracranial aneurysms of ≤10 mm with at least 6 months of imaging follow-up. Patients were separated into 2 groups: 1) those on an oral statin medication at the time of coiling, and 2) those who were not. Outcomes studied were aneurysm recurrence and aneurysm retreatment after endovascular coiling. Student t and χ(2) tests were used for statistical significance of differences between groups.


RESULTS
One hundred thirty-two patients with 132 ruptured aneurysms were included in our study. Sixteen were on statins (12.1%) and 116 were not (87.9%). The recurrence rate was 6.3% in the statin group (1/16) and 36.2% in the nonstatin group (42/107) (P = .02). Unplanned retreatment rates were 6.3% (1/16) for the statin group and 25.9% (30/116) for the nonstatin group (P = .08).


CONCLUSIONS
Statins were associated with a lower rate of aneurysm recurrence following endovascular coiling of small- and medium-sized ruptured aneurysms in this small retrospective study. Further studies are needed to confirm this finding to determine whether statins can be used to reduce recurrence rates in these aneurysms.
From the Department of Radiology (W.B., H.J.C., D.F.K., R.K.) brinjikji.waleed@mayo.edu.
W
http://orcid.org/0000-0001-5271-5524
W
Brinjikji
Mayo Medical School (V.S.).
V
V
Shahi
From the Department of Radiology (W.B., H.J.C., D.F.K., R.K.).
H J
HJ
Cloft
Department of Neurosurgery (G.L.), Mayo Clinic, Rochester, Minnesota.
G
http://orcid.org/0000-0003-1479-465X
G
Lanzino
From the Department of Radiology (W.B., H.J.C., D.F.K., R.K.).
D F
DF
Kallmes
From the Department of Radiology (W.B., H.J.C., D.F.K., R.K.).
R
R
Kadirvel
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors