Weill Cornell Neurovascular Laboratory

About Us

The Neurovascular Ultrasound Laboratory at Weill Cornell Medicine offers comprehensive diagnostic services for patients with neurovascular disorders such as stroke, transient ischemic attacks (TIAs), asymptomatic narrowing of the carotid arteries and of intracranial arteries, and aneurysms.

Our team of specialists have expertise in neurovascular ultrasound and perform non-invasive ultrasound studies using state-of-the-art methods to evaluate patients for narrowed arteries and other problems that cause strokes. Our lab provides a full battery of neurovascular ultrasound studies, including both carotid ultrasounds and transcranial Dopplers (TCD). Carotid ultrasounds assess the severity of blockages if any are present in the carotid arteries and can monitor these for changes over time. When appropriate, measurements of intimal medial thickness can be made to assess for the risk of developing atherosclerotic disease.

TCD tests examine blood flow in arteries inside the skull and provide important information about conditions that can cause strokes.

Why Choose the Weill Cornell Neurovascular Ultrasound Lab

The Neurovascular Ultrasound Lab is one of only a few dozen dedicated neurovascular ultrasound facilities certified in the United States by the Intersocietal Accreditation Commission (IAC). This accreditation confirms the quality of our testing for the diagnosis of vascular disease.

Services We Offer

Our lab offers a wide range of neurovascular diagnostic services onsite, including:

- Carotid ultrasound studies. Without using radiation or needles to evaluate narrowing of carotid arteries in the neck, these studies are for patients known or suspected to have carotid disease as a potential cause of stroke or TIA.

- Transcranial Doppler (TCD) ultrasound studies. TCD detects narrowing in the arteries inside the skull and assesses collateral blood flow, or blood flow that goes through alternative pathways to get around blocked arteries.

- TCD “bubble” studies. These tests detect holes that connect the two sides of the heart, which put some people at risk for stroke, especially younger patients who do not have conventional risk factors.

- TCD monitoring for circulating blood clots. Because clots traveling through arteries that supply the brain can plug these arteries and cause strokes, TCD monitoring for such clots can identify patients at high risk of stroke. It can also assess the effectiveness of treatments to prevent stroke in patients with cardiac or carotid sources of clots that can travel to the brain. We have cutting-edge TCD equipment with power M-mode technology, enabling highly sensitive detection of blood clots.

- TCD vasoreactivity studies. This test can assess the ability of arteries in the skull to increase blood flow under stress. Because the arteries in patients with severe carotid narrowing or complete blockage have a difficult time increasing blood flow, this test can assess stroke risk in these patients and help plan interventions.

Our Research

The lab is involved in research studies such as the CREST-2 and CREST-H studies, which are multicenter randomized NIH-sponsored trials studying the role of carotid endarterectomy and carotid stenting in preventing strokes and improving cognitive function in patients with asymptomatic carotid stenosis.

In another research project, the lab has used TCD to monitor cancer patients with stroke for circulating blood clots. This work found that such clots are associated with an increased risk of death in cancer patients and an increased risk of strokes, heart attacks and other problems related to abnormal blood clots. Another study performed in the lab reported that circulating blood clots are also found more frequently in patients with cancer and stroke than in patients with stroke or cancer alone.

The lab has also participated in a project using TCD to monitor patients receiving gene therapy for sickle cell disease. 

Our Team

Dr. Dana Leifer, medical director of the lab, and Drs. Nicholas Janocko and Babak Navi, are certified in Neurosonology by the American Society of Neuroimaging (ASN) and are available to interpret neurovascular ultrasound studies. They can also discuss the role of neurovascular ultrasound studies, help determine which studies would be appropriate for individual patients and assist in interpreting the clinical significance of studies. Along with other vascular neurologists in the department, they can provide full vascular neurologic consultations before and after ultrasound studies.

The lab's technical director, Richard Genova, BA, RVT, RPhS, NVS, and vascular technologist, Julia Narkalayeva, RVT, perform outpatient exams. They each have over a decade of experience in this diagnostic ultrasound subspeciality and are certified as Registered Vascular Technologists by the American Registry for Diagnostic Medical Sonography (ARDMS). Mr. Genova is also a national leader in neurosonology education and applications, and is a member of the Boards of Directors of the Intersocietal Accreditation Commission (IAC) Vascular Testing and the American Society of Neuroimaging (ASN). He authored a chapter on the “Use of Transcranial Doppler in the Outpatient Ultrasound Lab” for a highly regarded textbook in the field of clinical ultrasound, Neurovascular Sonography. Mr. Genova is also certified as a Neurovascular Specialist by the ASN. 

Request an Appointment

To schedule carotid or TCD studies or refer patients for these studies, or if you have questions regarding these studies, call (212) 746-2454. We look forward to assisting in the evaluation and care of patients with neurovascular problems.

Carotid and TCD studies can be ordered in the NewYork-Presbyterian/Weill Cornell Medical Center Epic system for outpatients. The location should be specified as "Weill Cornell Medicine (WCM)," the specialty as “Neurovascular,” and the Department as "STR 6 FLR Neurovascular Lab." Studies can usually be performed within a day. TCD studies can also be performed on in-patients at NewYork-Presbyterian/Weill Cornell Medical Center and can also be ordered through Epic.

Location

Parking is conveniently located across the street from the Starr Pavilion, and valet parking is available at the main entrance of NewYork-Presbyterian Hospital at 525 East 68th St.

Address:

520 East 70th St., Starr Pavilion, 6th Floor, Room 607

New York, NY 10021 

Telephone:

212-746-2454 

Fax:

646-962-0126