Safety and efficacy of a novel robotic transcranial doppler system in subarachnoid hemorrhage

Kevin Clare, Alan Stein, Nitesh Damodara, Eric Feldstein, Hussein Alshammari, Syed Ali, Christeena Kurian, Jon Rosenberg, Andrew Bauerschmidt, Gurmeen Kaur, Justin Santarelli, Robert Hamilton, Stephan Mayer, Chirag D. Gandhi, Fawaz Al-Mufti

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

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.

Original languageEnglish
Article number2266
JournalScientific Reports
Volume12
Issue number1
DOIs
StatePublished - Dec 2022
Externally publishedYes

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