Low-Dose Glucocorticoids Adjunctive to Flow Diverter Therapy for Unruptured Intracranial Aneurysms Improve…

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.

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BibTeX RIS

BibTeX

@article{wen2026lowdose,
  title = {{Low-Dose Glucocorticoids Adjunctive to Flow Diverter Therapy for Unruptured Intracranial Aneurysms Improve Cerebrovascular Outcomes}},
  author = {Zhuohua Wen and Xiheng Chen and Xin Tong and Chi Huang and Mengshi Huang and Jiancheng Lin and Anqi Xu and Hanyan Yang and Xiru Zhang and Yuanqi Lin and Jiwan Huang and Runze Ge and Hao Yuan and Chao Peng and Yanchao Liu and Fa Jin and Shixing Su and Xin Zhang and Xifeng Li and Zongduo Guo and Ming Lv and Aihua Liu and Chuanzhi Duan and Xin Feng},
  journal = {Nature Communications},
  year = {2026},
  month = oct,
  doi = {10.1038/s41467-026-78408-w},
  url = {https://www.nature.com/articles/s41467-026-78408-w},
  note = {CC BY 4.0},
}

RIS

TY  - JOUR
TI  - Low-Dose Glucocorticoids Adjunctive to Flow Diverter Therapy for Unruptured Intracranial Aneurysms Improve Cerebrovascular Outcomes
AU  - Zhuohua Wen
AU  - Xiheng Chen
AU  - Xin Tong
AU  - Chi Huang
AU  - Mengshi Huang
AU  - Jiancheng Lin
AU  - Anqi Xu
AU  - Hanyan Yang
AU  - Xiru Zhang
AU  - Yuanqi Lin
AU  - Jiwan Huang
AU  - Runze Ge
AU  - Hao Yuan
AU  - Chao Peng
AU  - Yanchao Liu
AU  - Fa Jin
AU  - Shixing Su
AU  - Xin Zhang
AU  - Xifeng Li
AU  - Zongduo Guo
AU  - Ming Lv
AU  - Aihua Liu
AU  - Chuanzhi Duan
AU  - Xin Feng
PY  - 2026
DA  - 2026/10/17
JO  - Nature Communications
DO  - 10.1038/s41467-026-78408-w
UR  - https://www.nature.com/articles/s41467-026-78408-w
AB  - 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.
SN  - 2041-1723
ER  -

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