Hemodynamic Monitoring

Cerebral hemodynamics are frequently impaired in a wide range of neurological diseases, including traumatic brain injury and stroke.

NovaSignal Platform for Cerebral Hemodynamic Monitoring

Continuous real-time data provides critical insight into embolic activity and blood flow, enabling immediate treatment decisions.

Envelope Trace Algorithm

Advanced algorithms focused on mean velocity accuracy

Signal Reacquisition

Extended monintoring with autonomous signal reacquistion upon patient movement

Patient Trends

Easy access to velocity trends over a 14-day period

Remote Monitoring

Monitor and interpret exams from anywhere

Vasospasm

Vasospasm is a pathological, diffuse, and long-lasting narrowing of a vessel lumen that can occur after subarachnoid hemorrhage (SAH).

Background & Prevalence

Occurring between 4 and 15 days after initial hemorrhage, vasospasm requires emergency detection and treatment.

Vasospasm has been reported in as many as
70%
of SAH patients 1
Vasospasm results in morbidity and mortality rates of 1
~30%
NovaSignal Benefit

Detection of vasospasm is critical but difficult as only 20-30% of cases present with notable clinical deficits. As the only bedside technology capable of monitoring, TCD is essential in the early identification of vasospasm after subarachnoid hemorrhage (SAH). TCD use is a guidelines-supported method for the detection of vasospasm with SEN and SPE of 91% and 71%, respectively.2

NovaSignal Platform for Vasospasm Detection

Envelope Trace Algorithm

Advanced algorithms focused on mean velocity accuracy

Customizable Protocols

Customize protocols based on personal exam preferences

Patient Trends

Easy access to velocity trends over a 14-day period

Remote Monitoring

Monitor and interpret exams from anywhere

NovaGuide has demonstrated in a series of publications that it can be used for SAH management and detection of vasospasm3
download the whitepaper
Clinical Support

Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage

Kumar G, Shahripour RB, Harrigan MR. Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis. J Neurosurg. 2016 May;124(5):1257-64.

View Publication

Robotically Assisted Transcranial Doppler With Artificial Intelligence For Assessment Of Cerebral Vasospasm After Subarachnoid Hemorrhage

Esmaeeli, S.; Mcvey, C.; Brenes Bastos, A.; Wang, J.; Gomez-Paz, S.; Hanafy, K.; Vasileios Arsenios, L.; Ogilvy, C.; Thomas, A.; Shaefi, S.; Fehnel, C.; Nozari, A. Robotically Assisted Transcranial Doppler With Artificial Intelligence For Assessment Of Cerebral Vasospasm After Subarachnoid Hemorrhage. Journal of NeuroCritical Care. June 19, 2020.

View Publication

Cerebral vasospasm and delayed cerebral ischemia: Review of literature and the management approach

Chugh C, Agarwal H. Cerebral vasospasm and delayed cerebral ischemia: Review of literature and the management approach. Neurol India. Jan-Feb 2019;67(1):185-200.

Guidelines for the management of aneurysmal subarachnoid hemorrhage

Connolly, E. S., Rabinstein, A. A., Carhuapoma, J. R., Derdeyn, C. P., Dion, J., Higashida, R. T., Hoh, B. L., Kirkness, C. J., Naidech, A. M., Ogilvy, C. S., Patel, A. B., Thompson, B. G., & Vespa, P. (2012). Guidelines for the management of aneurysmal subarachnoid hemorrhage: A guideline for healthcare professionals from the american heart association/american stroke association. Stroke. 43(6), 1711–1737.

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Sickle Cell Disease (SCD)

SCD is a genetic disorder in which individuals produce only abnormal hemoglobin, the molecule in red blood cells that delivers oxygen to the body. Under conditions of stress, this hemoglobin distorts the shape of red blood cells and leads to irreversible sickling.

Background & Prevalence

Sickled cells can occlude the microvasculature which results in the wide range of clinical symptoms seen in SCD. Over time, repeated episodes of sickling in the vessels of the brain result in scarring and progressive narrowing that can lead to stroke.

Worldwide
~300,000
children are born with sickle cell disease every year4
Every year
~60,000
children with SCD in sub-Saharan Africa suffer an ischemic stroke4
NovaSignal Benefit

Without treatment, 11% of children with sickle cell disease will have an ischemic stroke by 20 years of age. Transcranial Doppler (TCD) is used as a screening test to prevent this complication in the sickle cell population. A finding of elevated velocities requires further monitoring or transfusion intervention.5 TCD screening is recommended for SCD patients to begin at 24 months of age and should be repeated every 6-12 months during early childhood.6

Learn how Dr. Nicole O’Brien and Nationwide Children’s Hospital are using TCD to help treat sickle cell disease
download the guide
Clinical Support

TCD in sickle cell disease: an important and useful test

Adams R. J. (2005). TCD in sickle cell disease: an important and useful test. Pediatric radiology, 35(3), 229–234.

View Publication

Role of TCD in sickle cell disease: A review

Zétola V.F. (2012) Role of TCD in sickle cell disease: A review. Perspectives in Medicine, 1(1-12), 265-268.

View Publication

Extracorporeal Membrane Oxygenation (ECMO)

ECMO is a form of cardiopulmonary life support where blood is circulated outside the body and infused with oxygen before being recirculated back into the body.

Background & Prevalence
Intracerebral hemorrhage or infarction occurs in
~10-15%
of ARDS patients on ECMO7
43%
of ECMO deaths are dueto intracerebral hemorrhage7
NovaSignal Benefit

The automated NovaGuide can be used to assess cerebral blood flow velocity for extended periods of time while a patient is receiving ECMO support.

References:

  1. Mascia L, Del Sorbo L. Diagnosis and management of vasospasm. F1000 Med Rep. 2009
  2. Kumar G, Shahripour RB, Harrigan MR. Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis. J Neurosurg. 2016
  3. Esmaeeli, S.; Mcvey, C.; Brenes Bastos, A.; Wang, J.; Gomez-Paz, S.; Hanafy, K.; Vasileios Arsenios, L.; Ogilvy, C.; Thomas, A.; Shaefi, S.; Fehnel, C.; Nozari, A. Robotically Assisted Transcranial Doppler With Artificial Intelligence For Assessment Of Cerebral Vasospasm After Subarachnoid Hemorrhage. Journal of NeuroCritical Care. Apr 2020
  4. Marks, L. J., Munube, D., Kasirye, P., Mupere, E., Jin, Z., LaRussa, P., Idro, R., & Green, N. S. (2018). Stroke Prevalence in Children With Sickle Cell Disease in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Global pediatric health, 5, 2333794X18774970. https://doi.org/10.1177/2333794X18774970
  5. Naffaa, L. N., Tandon, Y. K., & Irani, N. (2015). Transcranial Doppler screening in sickle cell disease: The implications of using peak systolic criteria. World journal of radiology, 7(2), 52–56. https://doi.org/10.4329/wjr.v7.i2.52
  6. Adams R. J. (2005). TCD in sickle cell disease: an important and useful test. Pediatric radiology, 35(3), 229–234. https://doi.org/10.1007/s00247-005-1409-7
  7. Makdisi G, Wang I. Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis. 2015 Jul; 7(7): E166–E176.doi: 10.3978/j.issn.2072-1439.2015.07.17

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Emboli 
Monitoring
Perioperative
Monitoring
Embolic
Stroke
References
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