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Fifteen male freedivers underwent repetitive 3T pseudocontinuous ASL and ³¹P-/¹H-MR spectroscopy before, during, and after a 5-minute breath-hold (split into early and late phases) and gave temporally matching venous blood gas samples. The spatial coefficient of variation of CBF (by arterial spin-labeling) decreased during the early breath-hold phase whereas CBF remained almost stable during this phase and increased in the late phase. Cerebrovascular reactivity differed between the anterior and the posterior circulation during all phases. The cerebral energy metabolism of trained freedivers withstands severe hypoxic hypercarbia in prolonged breath-hold due to a complex cerebrovascular hemodynamic response.

An intention-to-treat single-center cohort (n= 592) was re-evaluated for all patients in whom no reperfusion could be achieved (n = 63). Baseline characteristics were compared between patients with and without reperfusion failures. After qualitative review of all cases with reperfusion failures, a classification system was proposed and relative frequencies were reported. Reasons for reperfusion failure in stent-retriever thrombectomy are heterogeneous. The failure to establish intracranial or cervical access is almost as common as stent-retriever failure after establishing intracranial access. Systematic reporting standards of reasons may help to further estimate relative frequencies and thereby guide priorities.