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Purpose: Optimal systolic blood pressure (SBP) management during endovascular treatment (EVT) for acute ischemic stroke remains a topic of debate. Though BP is associated with worse functional outcome, the relationship between BP and post-procedural intracranial hemorrhage (ICH) is less well-known. We aimed to investigate the association between BP during EVT and post-procedural ICH on dual-energy CT (DECT). Methods: We included all patients who underwent EVT for an anterior circulation large vessel occlusion between 2010 and 2019, and received DECT < 3 h post-EVT. All BP measurements during the EVT procedure were used to calculate mean arterial pressure (MAP mean), mean SBP (SBP mean), and SBP max-min (highest minus lowest). ICH was assessed using virtual post-procedural unenhanced DECT reconstructions and classified as intraparenchymal or extraparenchymal. Symptomatic ICH was scored according to the Heidelberg criteria. The association between different BP parameters and ICH was assessed using multivariable logistic regression. Results: We included 478 patients. Seventy-six patients (16%) demonstrated ICH on DECT, of which 26 (34%) were intraparenchymal. Symptomatic intraparenchymal and extraparenchymal ICH occurred in 10 (38%) and 4 (8%) patients. SBP max, SBP mean, and MAP mean were associated with intraparenchymal ICH with an adjusted odds ratio of 1.19 (95%CI, 1.02–1.39), 1.22 (95%CI, 1.03–1.46), and 1.40 (95%CI, 1.09–1.81) per 10 mmHg, while BP was not significantly associated with extraparenchymal ICH. BP did not differ between asymptomatic and symptomatic ICH. Conclusion: Procedural BP is associated with intraparenchymal ICH on post-EVT DECT but not with extraparenchymal ICH. Future studies should evaluate whether individual procedural BP management reduces post-EVT ICH and improves clinical outcome. Graphical Abstract: (Figure presented.)

Background: Endovascular treatment for anterior circulation ischaemic stroke is effective and safe within a 6 h window. MR CLEAN-LATE aimed to assess efficacy and safety of endovascular treatment for patients treated in the late window (6–24 h from symptom onset or last seen well) selected on the basis of the presence of collateral flow on CT angiography (CTA). Methods: MR CLEAN-LATE was a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial done in 18 stroke intervention centres in the Netherlands. Patients aged 18 years or older with ischaemic stroke, presenting in the late window with an anterior circulation large-vessel occlusion and collateral flow on CTA, and a neurological deficit score of at least 2 on the National Institutes of Health Stroke Scale were included. Patients who were eligible for late-window endovascular treatment were treated according to national guidelines (based on clinical and perfusion imaging criteria derived from the DAWN and DEFUSE-3 trials) and excluded from MR CLEAN-LATE enrolment. Patients were randomly assigned (1:1) to receive endovascular treatment or no endovascular treatment (control), in addition to best medical treatment. Randomisation was web based, with block sizes ranging from eight to 20, and stratified by centre. The primary outcome was the modified Rankin Scale (mRS) score at 90 days after randomisation. Safety outcomes included all-cause mortality at 90 days after randomisation and symptomatic intracranial haemorrhage. All randomly assigned patients who provided deferred consent or died before consent could be obtained comprised the modified intention-to-treat population, in which the primary and safety outcomes were assessed. Analyses were adjusted for predefined confounders. Treatment effect was estimated with ordinal logistic regression and reported as an adjusted common odds ratio (OR) with a 95% CI. This trial was registered with the ISRCTN, ISRCTN19922220. Findings: Between Feb 2, 2

This paper develops algebraic and convergence properties of the left and right block reflectors used in the block diagonalization algorithm. Several numerical illustrations are reported.

The evaluation of the response of elastic structures subjected to distributed random excitations is usually performed in the modal space. Random excitations (like acoustic diffuse fields) are usually modeled as weakly stationary random processes and are assumed to be homogeneous. Their characterization basically relies on the power spectral density (PSD) function of the pressure at a particular reference position and a suitable spatial correlation function. In the modal space, the distributed random excitation is characterized by a modal PSD matrix made from the joint acceptance functions related to the mode pairs. The joint acceptance function is a double surface integral involving the product of the considered mode shapes and the spatial correlation function. The paper shows how to evaluate efficiently this quadruple integral for cylindrical and truncated conical structures excited by an acoustic diffuse field. Basically, the procedure relies on the derivation of alternative expressions for the spatial correlation function. The related expressions prove to be more convenient for these geometries and are leading to a reduction of the double surface integral to a combination of simple integrals. A very substantial breakdown of the computational cost can be achieved using the resulting expressions. (c) 2005 Acoustical Society of America.

We discuss convergence properties of the GMRES and FOM methods for solving large Sylvester equations of the form AX-XB=C. In particular we show the importance of the separation between the fields of values of A and B on the convergence behavior of GMRES. We also discuss the stagnation phenomenon in GMRES and its consequence on FOM. We generalize the issue of breakdown in the block-Arnoldi algorithm and explain its consequence on FOM and GMRES methods. Several numerical tests illustrate the theoretical results.