Background and purpose A number of studies have examined the role of matrix metalloproteinases (MMPs) in aneurysm healing following endovascular coiling. Because ruptured aneurysms are known to express higher levels of MMPs, we hypothesized that subarachnoid hemorrhage patients who were on a statin at the time of coil embolization would have lower aneurysm recanalization and retreatment rates than non-statin patients.
Materials and Methods We performed a retrospective chart review of patients who received intrasaccular coil embolization of ruptured intracranial aneurysms≤10 mm with at least 6-months of imaging follow-up. Patients were separated into two groups: 1) patients who were on an oral statin medication at the time of coiling and 2) patients who were not on a statin. Outcomes studied were aneurysm recurrence and aneurysm retreatment after endovascular coiling. Student’s t-test and chi-squared tests were used to test statistical significance of differences between groups.
Results 132 ruptured aneurysm patients with 132 ruptured aneurysms were included in our study. 16 were on statin (12.1%) and 116 were not (87.9%). Recurrence rates were significantly lower in the statin group than in the non-statin group. Recurrence rates were 6.3% (1/16) for the statin group and 36.2% (41/116) for the non-statin group (P = 0.017). There was a trend towards lower retreatment rate in the statin group. Unplanned retreatment rates were 6.3% (1/16) for the statin group and 25.9% (30/116) for the non-statin group (P = 0.08). The only baseline characteristics that differed between the statin and non-statin groups were mean age. When considering patients with ruptured aneurysms 10 mm or small and adjusting for age, statin use was associated with a significantly lower odds of recurrence (OR=0.13, 95% CI=0.01–0.72, P = 0.016) and a non-statistically significant lower odds of retreatment (OR==0.29, 95% CI=0.01–1.55, P = 0.16).
Conclusions Statins were associated with a lower rate of aneurysm recurrence following endovascular coiling of small and medium sized ruptured aneurysms in this retrospective study. Further studies are needed to confirm this finding to determine if statins can be used to reduce recurrence rates in these aneurysms.
Disclosures W. Brinjikji: 1; C; Brain Aneurysm Foundation. V. Shahi: None. H. Cloft: None. G. Lanzino: 2; C; Covidien. D. Kallmes: 1; C; Covidien. R. Kadirvel: None.
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