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.
NeuraSignal Platform for Emboli Monitoring
TCD ultrasound is currently the gold-standard test to detect, localize, and quantify cerebral embolism.
Clear exam results with emboli automatically flagged for review
Extended monitoring with autonomous signal reacquisition upon patient movement
Safe tracking of patient progress in real time for the full exam duration
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
NeuraSignal 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.
NeuraSignal Platform for Perioperative Monitoring
Learn more about how the real-time blood flow data provided by the NueraSignal Platform allows clinicians to immediately respond to perioperative concerns
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.
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.
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.
NeuraSignal 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.
NeuraSignal Platform for Emboli Monitoring
Learn more about how the real-time blood flow data provided by the NeuraSignal Platform allows clinicians to immediately respond to embolic activity.
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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By providing noninvasive monitoring of cerebral hemodynamics, the NeuraSignal Platform can reduce the need for more invasive and costly procedures, delivering cost savings and increasing efficiency.
With real-time information, clinical teams can make more informed decisions about patient management, leading to reduced length of stay and improving patient outcomes.
With the NeuraSignal Platform, healthcare professionals can detect and manage complications more quickly, helping to prevent adverse outcomes, reduce hospital readmissions, and ultimately leading to better patient satisfaction.
References
- 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.
- Proposed Standardized Neurological Endpoints for Cardiovascular Clinical Trials. Alexandra J. Lansky, MD. Eur Heart J. 2018 May 14; 39(19): 1687–1697.
- 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
- 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/