Low-Dose Glucocorticoids Adjunctive to Flow Diverter Therapy for Unruptured Intracranial Aneurysms Improve Cerebrovascular Outcomes
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.
Authors
- 苏世星
- Xin Tong (ORCID: https://orcid.org/0000-0002-4893-1299)
- Chao Peng (ORCID: https://orcid.org/0000-0003-3099-2808)
- Ming Lv (ORCID: https://orcid.org/0000-0003-1865-2309)
- Chuan‐Zhi Duan (ORCID: https://orcid.org/0000-0001-7749-7594)
- Xifeng Li (ORCID: https://orcid.org/0000-0003-4393-1916)
- Anqi Xu (ORCID: https://orcid.org/0000-0003-0518-5473)
- Yuanqi Lin (ORCID: https://orcid.org/0000-0001-6746-9821)
- Aihua Liu (ORCID: https://orcid.org/0009-0004-9572-5692)
- Mengshi Huang
- Jiwan Huang (ORCID: https://orcid.org/0009-0004-3993-756X)
- Runze Ge (ORCID: https://orcid.org/0009-0002-0778-1199)
- Hanyan Yang (ORCID: https://orcid.org/0009-0003-4830-795X)
- Zhuohua Wen
- Yanchao Liu
- Xin Feng
- Jiancheng Lin
- Chi Huang
- Fa Jin
- Xiheng Chen
- Xin Zhang
- Hao Yuan
- Zongduo Guo
- Xiru Zhang
Institutions
- Capital Medical University (CN)
- Beijing Chao-Yang Hospital, Capital Medical University (CN)
- Beijing Tian Tan Hospital (CN)
- National Clinical Research Center for Digestive Diseases (CN)
- Beijing Anzhen Hospital (CN)
- Zhujiang Hospital (CN)
- The Affiliated Yongchuan Hospital of Chongqing Medical University (CN)
- Guangdong Academy of Medical Sciences (CN)
- Southern Medical University (CN)
Publication Details
- Journal
- Nature Communications
- Published
- 2026-10-17
- DOI
- https://doi.org/10.1038/s41467-026-78408-w
- Primary Topic
- Intracranial Aneurysms: Treatment and Complications
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Natural Science Foundation of China
- Southern Medical University
- National Health Commission of the People's Republic of China