Researchers are exploring how MR imaging tracks atorvastatin’s effect on inflammation in unruptured vertebrobasilar dissecting aneurysms (VBDAs), a significant stroke risk.

Statins are already known to help treat intracranial saccular aneurysms, but their role in VBDAs has been far less clear. That gap is now coming into focus. Published in Radiology, this randomized controlled trial followed 40 patients with unruptured VBDAs. Over six months, participants were assigned to either a daily 20 mg dose of atorvastatin or a placebo.

Using vessel wall MR, researchers measured aneurysm wall enhancement, a well-established marker of inflammation. The imaging offered a detailed, real-time look at changes within the vessel wall and represents a meaningful step forward in tracking how these aneurysms evolve over time, says lead author Yisen Zhang, M.D., of Beijing Tiantan Hospital and Beijing Neurosurgical Institute.
The results drew a clear distinction between the two groups. Patients receiving atorvastatin saw significant reductions in both the wall enhancement index (WEI) and the wall enhancement volume rate (WEVR), two measures tied to inflammatory activity.

WEI fell by 0.3 in the atorvastatin group, compared with a 0.1 increase among patients on placebo. WEVR dropped by 15.1% with statin therapy, while rising 5.3% in the placebo group. Together, the findings suggest atorvastatin may help reduce inflammation and improve aneurysm stability, according to the study authors.

Blood tests told a similar story. Levels of several inflammatory markers, including C-reactive protein; tumor necrosis factor α; interleukin-6; and interleukin-1β; were all lower in the atorvastatin group than in the placebo group, pointing to a broader anti-inflammatory effect. Notably, aneurysm size remained stable in both groups. But patients taking atorvastatin experienced less progression of internal bleeding within the vessel wall compared with those with the placebo.

Together, the findings suggest atorvastatin could play a role in managing VBDAs by tamping down inflammation and potentially lowering rupture risk. The authors caution, however, that larger and longer-term studies are still needed to determine whether these imaging and biologic changes translate into improved patient outcomes.

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