COMBINED APPROACH TO THE NON-INVASIVE DIAGNOSIS OF CAROTID-ARTERY OCCLUSIVE DISEASE

  • 1 January 1979
    • journal article
    • research article
    • Vol. 85  (6) , 689-694
Abstract
A combined approach utilizing ophthalmosonometry (OSM), carotid phonoangiography (CPA) and ocular pneumoplethysmography (OPG) was applied to 311 patients with symptoms of carotid artery occlusive disease. Arteriograms were obtained in 70 patients, allowing the accuracy of each technique to be assessed in 140 carotid arteries. Doppler OSM and OPG correctly identified all complete occlusions of the internal carotid artery. Greater than 50% stenoses were detected by OSM in only 52% and by OPG in 87%. The cumulative accuracy in detecting hemodynamically significant lesions was 76% for OSM and 93% for OPG. Addition of CPA to OPG raised the combined accuracy of the 2 techniques to 98% for significant carotid lesions. The development of a regression line criterion for the OPG, in combination with CPA, permitted identification of 100% of patients with bilateral carotid artery lesions. About 73% of patients with symptomatic, ulcerating plaques were missed by all 3 tests, emphasizing the need for angiography in appropriately symptomatic patients. Noninvasive testing is useful in evaluating patients with carotid artery occlusive disease for asymptomatic bruits, atypical, nonhemispheric symptoms or following carotid endarterectomy.