Effect of Statin Therapy following Endovascular Treatment of Intracranial Aneurysms: A Meta-Analysis

Endovascular treatment has become one of the standard therapies for intracranial aneurysms (IAs), yet the prognosis remains a persistent clinical challenge. This study aimed to systematically evaluate the efficacy and safety of adjuvant statin therapy following endovascular treatment (EVT) of IAs.

A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. Cohort studies comparing outcomes between patients with IAs who received statin therapy following EVT and those who did not were included. Efficacy outcomes included retreatment, recurrence, and complete occlusion, whereas safety outcomes included ischemic stroke, intracerebral hemorrhage (ICH), thrombosis, and all-cause mortality. A random-effects model was applied, and subgroup and sensitivity analyses were performed on the basis of treatment modality and adjustment for confounding factors.

Six retrospective studies comprising 3,692 patients were analyzed. Sensitivity analysis revealed that statin therapy significantly reduced the risk of retreatment (adjusted odds ratio [aOR] 0.35, 95% CI: 0.15-0.81) and recurrence (aOR 0.29, 95% CI: 0.12-0.65), whereas no significant difference was found in complete occlusion rates (aOR 0.94, 95% CI: 0.52-1.71). Although the unadjusted risk of ischemic stroke was greater in the statin group, this association was not significant after adjustment (aOR 1.04, 95% CI: 0.30-3.60). No significant differences were observed in other safety outcomes, including ICH, thrombosis, or all-cause mortality.

Statins may help reduce the risk of recurrence and retreatment of IAs following EVT, suggesting their potential adjunctive role in the management of IAs and providing a rationale for conducting prospective investigations.