Purpose: The purpose of this study was to report the author’s experiences in treating large (10–25 mm) and giant (>25 mm) intracranial aneurysms (IAs) using a single Flow Re-direction Endoluminal Device (FRED) without assistant coiling, with a focus on procedure-related complications. Materials and Methods: A total of 33 patients who were treated with FRED between January 2018 and July 2020 were retrospectively reviewed. The timing of procedure-related complications was chronologically categorized as acute (within 7 days), subacute (8 to 21 days), and delayed (after 21 days) periods. Follow-up angiography was performed at 2 to 27 months (mean 9.7 months), and clinical follow-up was performed at 1 to 31 months (mean 14.1 months) in all patients. Results: Six (18.2%) patients experienced procedure-related complications, including 2 (6.1%) in acute period, 1 (3.0%) in subacute period, and 3 (9.1%) in delayed period. Thromboembolic complications occurred in 5 (15.2%) patients and hemorrhagic complications in 1 (3.0%). Permanent morbidity and mortality rates were 3.0% each. Non-internal carotid artery (ICA) location of IAs (odds ratio 6.532; 95% confidence interval, 1.335–17.816; p=0.034) was the only independent risk factor for procedure-related complications on multivariate logistic regression analysis. Conclusion The procedure-related complication rate was 18.2% in this study. Procedure-related complications might increase when treating large and giant IAs located on a non-ICA, especially on the middle cerebral artery. Therefore, it may be suggested that neurointerventionists and endovascular neurosurgeons should pay attention to the location of IAs when treating large and giant IAs with a single FRED.

Hemodynamics in 60 normal, 15 simple goiter and 40 hyperthyroid subjects were determined from non-invasive Wezler's method. Hemodynamic changes in hyperthyroid patients were compared with those of normal subjects. The relationships of the cardiac output, aging,131I uptake rate and PEP/LVET to the hemodynamic changes in Hyperthyroid patients were also discussed. 1) The hemodynamics of normal subjects were same as those of simple goiter. 2) The heart rate and cardiac output were increased very significantly in hyperthyroid patients but they appeared to decrease with age. The stroke volume was increased slightly in the hyperthyroid patients, but remained unlateerd even with aging. Peripheral arterial resistance in hyperthyroid patients was decreased but appeared to increase with age. 3) As the131I uptake rate increased, the heart rate, cardiac output also increased, but PEP/LVET as an index of myocardial contractility and the peripheral arterial resistance decreased. 4) PEP/LVET as an index of myocardial contractility in hyperthyroid patients was markedly reduced. 5) The relationship of stroke volume and the rate of the heart to cardiac output in normal subjects were reasonably linear, and peripheral arterial resistance has negative relation to cardiac output. However the heart rate, though increased in most patients with thyrotoxicosis, bears no close relations to the level of cardiac output increment. The relationshop of stroke volume to cardiac output in hyperthyroid patients is reasonably linear and peripheral arterial resistance has negative correlation with the cardiac output.
Aging ; Cardiac Output ; Goiter ; Heart ; Heart Rate ; Hemodynamics* ; Humans ; Stroke Volume ; Thyrotoxicosis