NYMC Faculty Publications

Safety and Efficacy of a Novel Robotic Transcranial Doppler System in Subarachnoid Hemorrhage

Authors

Kevin Clare, New York Medical College School of Medicine, Valhalla, NY, USA.
Alan Stein, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Nitesh Damodara, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Eric Feldstein, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Hussein Alshammari, Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
Syed Ali, Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
Christeena Kurian, Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
Jon Rosenberg, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Andrew Bauerschmidt, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Gurmeen Kaur, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Justin Santarelli, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Robert Hamilton, NovaSignal Corp., Los Angeles, CA, USA.
Stephan Mayer, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Chirag D. Gandhi, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA.
Fawaz Al-Mufti, Department of Neurosurgery, Westchester Medical Center at New York Medical College, 100 Woods Road, Macy Pavilion 1331, Valhalla, NY, 10595, USA. fawaz.al-mufti@wmchealth.org.

Author Type(s)

Faculty, Resident/Fellow

Journal Title

Scientific Reports

First Page

2266

Document Type

Article

Publication Date

2-10-2022

Department

Neurology

Second Department

Neurosurgery

Abstract

Delayed cerebral ischemia (DCI) secondary to vasospasm is a determinate of outcomes following non-traumatic subarachnoid hemorrhage (SAH). SAH patients are monitored using transcranial doppler (TCD) to measure cerebral blood flow velocities (CBFv). However, the accuracy and precision of manually acquired TCD can be operator dependent. The NovaGuide robotic TCD system attempts to standardize acquisition. This investigation evaluated the safety and efficacy of the NovaGuide system in SAH patients in a Neuro ICU. We retrospectively identified 48 NovaGuide scans conducted on SAH patients. Mean and maximum middle cerebral artery (MCA) CBFv were obtained from the NovaGuide and the level of agreement between CBFv and computed tomography angiography (CTA) for vasospasm was determined. Safety of NovaGuide acquisition of CBFv was evaluated based on number of complications with central venous lines (CVL) and external ventricular drains (EVD). There was significant agreement between the NovaGuide and CTA (Cohen's Kappa = 0.74) when maximum MCA CBFv ≥ 120 cm/s was the threshold for vasospasm. 27/48 scans were carried out with CVLs and EVDs present without negative outcomes. The lack of adverse events associated with EVDs/CVLs and the strong congruence between maximal MCA CBFv and CTA illustrates the diagnostic utility of the NovaGuide.

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