Nature Communications· 2026Q1
Low-Dose Glucocorticoids Adjunctive to Flow Diverter Therapy for Unruptured Intracranial Aneurysms Improve Cerebrovascular Outcomes
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- Q1SCImago
- 2026year
Short summary
Short-term, low-dose glucocorticoid use initiated within 2 hours of flow diverter implantation for unruptured intracranial aneurysms reduced in-hospital cerebrovascular events by 45% and major cerebrovascular events by 63% compared to controls.
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Key points
- Perioperative glucocorticoid use reduced in-hospital cerebrovascular events by 45% (aOR 0.53) in flow diverter treated patients.
- Major cerebrovascular events were reduced by 63% (aOR 0.37) in the glucocorticoid group during hospitalization.
- Over 2 years, glucocorticoid use was associated with a 59% reduction in new-onset major cerebrovascular events (aHR 0.41).
- In-stent stenosis was reduced by 45% (aOR 0.55) in patients receiving glucocorticoids.
AI-generated from the title and abstract; the full text is not read.
Abstract
Abstract Flow diverter (FD) implantation is standard for unruptured intracranial aneurysms (UIAs), but cerebrovascular complications persist. This nested study within a prospective multicenter cohort evaluates whether short-term, low-dose glucocorticoid use is associated with cerebrovascular outcomes after FD implantation. Propensity-score matching with exact matching on UIA location yielded 1327 patients (360 glucocorticoid-treated; 967 controls). Intravenous glucocorticoids, initiated within 2 hours of the FD procedure and administered for ≥2 days, were associated with fewer in-hospital cerebrovascular events (6.9% vs. 13.1%; adjusted odds ratio [aOR], 0.53) and major cerebrovascular events (4.7% vs. 12.4%; aOR, 0.37). Over a median 2-year follow-up, glucocorticoid use was also associated with fewer new-onset major cerebrovascular events (3.6% vs. 8.7%; adjusted hazard ratio, 0.41) and less in-stent stenosis (7.9% vs. 13.2%; aOR, 0.55). Findings remained robust in unmatched patients on sensitivity analyses. We demonstrate that perioperative glucocorticoid regimens may reduce cerebrovascular events and in-stent stenosis in FD-treated patients, warranting randomized trials.
The authors' abstract, as published at the source. Nature Communications, 2026 · DOI ↗
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Field: Neurology (Medicine)
NeurologyMedicine