Lack of Association between Statin Use and Angiographic and Clinical Outcomes after Pipeline Embolization for Intracranial Aneurysms.
Use of statin medications has been demonstrated to improve clinical and angiographic outcomes in patients receiving endovascular stent placement for coronary, peripheral, carotid, and intracranial stenoses. We studied the impact of statin use on long-term angiographic and clinical outcomes after flow-diverter treatment of intracranial aneurysms.



We performed a post hoc analysis from pooled patient-level datasets from 3 Pipeline Embolization Device studies: the International Retrospective Study of the Pipeline Embolization Device, the Pipeline for Uncoilable or Failed Aneurysms Study, and the Aneurysm Study of Pipeline in an Observational Registry. We analyzed data comparing 2 subgroups: 1) patients on statin medication, and 2) patients not on statin medication at the time of the procedure and follow-up. Angiographic and clinical outcomes were compared by using the χ2test, Fisher exact test, or Wilcoxon rank sum test.



We studied 1092 patients with 1221 aneurysms. At baseline, 226 patients were on statin medications and 866 patients were not on statin medications. The mean length of clinical and angiographic follow-up was 22.1 ± 15.1 months and 28.3 ± 23.7 months, respectively. There were no differences observed in angiographic outcomes at any time point between groups. Rates of complete occlusion were 82.8% (24/29) versus 86.4% (70/81) at 1-year (P= .759) and 93.3% (14/15) versus 95.7% (45/47) at 5-year (P= 1.000) follow-up for statin-versus-nonstatin-use groups, respectively. There were no differences in any complication rates between groups, including major morbidity and neurologic mortality (7.5% versus 7.1%,P= .77).



Our study found no association between statin use and angiographic or clinical outcomes among patients treated with the Pipeline Embolization Device.
From the Department of Radiology (W.B., H.C., D.F.K.), Mayo Clinic, Rochester, Minnesota brinjikji.waleed@mayo.edu.
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0000-0001-5271-5524
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Brinjikji
From the Department of Radiology (W.B., H.C., D.F.K.), Mayo Clinic, Rochester, Minnesota.
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0000-0003-2590-3815
H
Cloft
Department of Radiology (S.C.), Koru Hospital and Bayindir Hospitals, Ankara, Turkey.
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0000-0002-4521-2301
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Cekirge
Department of Neurosurgery (D.F.), Cerebrovascular Center, Stony Brook University Medical Center, Stony Brook, New York.
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0000-0002-2677-8780
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Fiorella
Stroke and Cerebrovascular Surgery (R.A.H.), Lyerly Neurosurgery/Baptist Neurological Institute, Jacksonville, Florida.
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0000-0001-7195-5806
RA
Hanel
Department of Neurosurgery (P.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
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0000-0002-8965-2413
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Jabbour
Department of Neurosurgery (P.L.), Equipo de Neurocirugía Endovascular y Radiología Intervencionista de Buenos Aires-Clinica La Sagrada Familia, Buenos Aires, Argentina.
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0000-0001-7044-4369
P
Lylyk
Department of Endovascular Neurosurgery (C.McDougall), Barrow Neurological Institute, Phoenix, Arizona.
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0000-0001-7372-7049
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McDougall
Division of Interventional Neuroradiology (C.Moran), Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
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0000-0001-5559-3390
C
Moran
Department of Neurosurgery (A.S.), University at Buffalo Neurosurgery, Buffalo, New York.
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0000-0002-9519-0059
A
Siddiqui
Department of Neurointerventional Services (I.S.), National Institute of Clinical Neurosciences, Budapest, Hungary.
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0000-0003-3730-3278
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Szikora
From the Department of Radiology (W.B., H.C., D.F.K.), Mayo Clinic, Rochester, Minnesota.
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0000-0002-8495-0040
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Kallmes
D000368:Aged; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors