Neuralert Stroke Monitor Trial

Inclusion Criteria: (all must be yes)

• Male or female age ≥ 22 years
• Admitted or planned admission to one of the participating hospitals and followed by the Cardiothoracic (CT) Surgery or Vascular Surgery services
• Considered at high risk for stroke while in the hospital based on:

• Interventions or procedures that are high-risk for stroke performed during the hospitalization, which may include:

• Intracardiac surgical or endovascular procedures, including valve replacement
• Ascending aorta or aortic arch surgical or endovascular repair
• Open surgical or endovascular carotid revascularization
• Other cardiac procedures along with a high-risk medical history:

• Age ≥ 80 years
• Prior stroke/ transient ischemic attack (TIA)
• Hypercoagulable state (i.e., prior clotting events attributed to active malignancy or a diagnosed thrombophilia) requiring lifelong anticoagulation
• Severely reduced left ventricular cardiac ejection fraction (i.e., \<30%) or anterior left ventricular wall akinesis
• Atrial fibrillation

Exclusion Criteria: (all must be no)

• Any medical or psychological conditions that, in the opinion of the investigator, would compromise the subject's safety or successful participation in the study
• Baseline preoperative asymmetric upper extremity weakness as assessed by the Investigator, defined as a differential in the NIHSS upper extremity motor score between the two arms of >0
• Above the wrist amputation
• Unwilling to provide informed consent or no legally authorized representative willing to provide consent if the patient is unable
• Currently imprisoned