Emboli Monitoring

A cerebral embolism occurs when a blood clot forms in another part of the body, often the heart or arteries in the upper chest and neck, and moves through the bloodstream until it hits an artery too narrow to let it pass.

NovaSignal Platform for Emboli Monitoring

TCD ultrasound is currently the gold-standard test to detect, localize, and quantify cerebral embolism.

Emboli Algorithm

Clear exam results with emboli automatically flagged for review

Signal Reacquisition

Extended monitoring with autonomous signal reacquisition upon patient movement

Non-Invasive Monitoring

Safe tracking of patient progress in real time for the full exam duration

Remote Monitoring

Live exam streaming with notification of key events

Perioperative Monitoring

There is a significant risk of stroke during cardiac procedures due to embolic activity or lack of blood flow.

Background & Prevalence

Electroencephalography (EEG) is often used to monitor the status of neuronal activity in the brain during surgery. However, a recent case study of patients undergoing carotid endarterectomy revealed that TCD correctly indicated injury that resulted in transient functional deficits, while EEG did not.1

Every year up to
600,000
patients in the US suffer a brain injury during or after a cardiovascular procedure2
Patients undergoing heart surgery who experience perioperative stroke have a
5-10X
higher risk of in-hospital death3
NovaSignal Benefit

Continuous real-time data provides critical insight into embolic activity and blood flow, enabling immediate treatment decisions while the patient is still in the operating room.

NovaSignal Platform for Perioperative Monitoring

Learn more about how the real-time blood flow data provided by the NovaSignal Platform allows clinicians to immediately respond to perioperative concerns

download THE CASE
Clinical Support

Cerebral Injury Predicted by Transcranial Doppler Ultrasonography But Not Electroencephalography During Carotid Endarterectomy

Costin M, Rampersad A, Solomon RA, Connolly SS, Heyer EJ. Cerebral Injury Predicted by Transcranial Doppler Ultrasonography But Not Electroencephalography During Carotid Endarterectomy. J Neurosurg Anesthesiol. 2002 Oct;14(4):287-92.

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Guidelines for Carotid Endarterectomy

Moore WS, Barnett HJM, Beebe HG, Bernstein EF,  Brener BJ, Brott T, Caplan LR, Day A, GoldstoneJ, Hobson II RW, Kempczinski RF, Matchar DB, Mayberg MR, Nicolaides AN, NorrisJW, Ricotta JJ, Robertson JT, Rutherford RB, Thomas D, Toole JF, Trout III HH,  Wiebers DO. Guidelines for Carotid Endarterectomy. Circulation. 1995;91:566–579.

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Embolic Stroke

Careful evaluation and workup for an embolic source is mandatory to guide appropriate evidence-based treatment and reduce the risk of stroke recurrence.

Background & Prevalence

There are three main mechanisms that can cause an ischemic stroke; thrombosis, hypoperfusion, or emboli. Ischemic strokes of cardioembolic source are generally the most severe ischemic stroke subtype.

87%
of all strokes are ischemic strokes, where blood flow to the brain is blocked4
15%
of embolic strokes occur in people with atrial fibrillation4
NovaSignal Benefit

The spatial and temporal resolution of TCD ultrasound make it the gold-standard test to detect, localize, and quantify cerebral embolism. TCD is also useful in detection of the embolic source (heart vs. brain) and any underlying vascular pathology. TCD is recommended for emboli monitoring in patients with embolic stroke of undetermined source (ESUS) with no obvious source of plaque and only minor stenosis, but present atrial fibrillation.

NovaSignal Platform for Emboli Monitoring

Learn more about how the real-time blood flow data provided by the NovaSignal Platform allows clinicians to immediately respond to embolic activity

download THE CASE
Clinical Support

Practice Standards for Transcranial Doppler (TCD) Ultrasound. Part III

Alexandrov, A. V., Sloan, M. A., Tegeler, C. H., Newell, D. N., Lumsden, A., Garami, Z., Levy, C. R., Wong, L. K., Douville, C., Kaps, M., Tsivgoulis, G., & American Society of Neuroimaging Practice Guidelines Committee (2012). Practice standards for transcranial Doppler (TCD) ultrasound. Part II. Clinical indications and expected outcomes. Journal of neuroimaging : official journal of the American Society of Neuroimaging, 22(3), 215–224.

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References:

  1. Costin M, Rampersad A, Solomon RA, Connolly SS, Heyer EJ. Cerebral Injury Predicted by Transcranial Doppler Ultrasonography But Not Electroencephalography During Carotid Endarterectomy. J Neurosurg Anesthesiol.
  2. Proposed Standardized Neurological Endpoints for Cardiovascular Clinical Trials. Alexandra J. Lansky, MD. Eur Heart J. 2018 May 14; 39(19): 1687–1697.
  3. Gaudino M, Benesch C, Bakaeen F, DeAnda A, Fremes SE, Glance L, Messé SR, Pandey A, Rong LQ; on behalf of the American Heart Association Council on Cardiovascular Surgery and Anesthesia; Stroke Council; and Council on Cardiovascular and Stroke Nursing. Considerations for reduction of risk of perioperative stroke in adult patients undergoing cardiac and thoracic aortic operations: a scientific statement from the American Heart Association. Circulation. 2020; 142:e193–e209. doi: 10.1161/CIR.0000000000000885
  4. Ibrahim F, Murr N. Embolic Stroke. [Updated 2021 Oct 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564351/

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Emboli 
Monitoring
Perioperative
Monitoring
Embolic
Stroke
References
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