Doppler cerebrovascular examination, oculoplethysmography, and ocular pneumoplethysmography use in detection of carotid disease: a prospective clinical study.
To determine the comparative acccuracy of three noninvasive cerebrovascular testing systems, 72 patients underwent complete evaluation by Doppler cerebrovascular examination (DCE), oculoplethysmography (OPG-Kartchner), ocular pneumoplethysmography (OPG-Gee), and angiography. Considering 60% diameter stenosis or more by angiography as a true positive finding, the noninvasive tests of the 72 patients showed the following results: DCE, two false-positive, 17 false-negative, and 53 correct with an overall accuracy of 74%; OPG-Kartchner, six false-positive, four false-negative, and 62 correct with an overall accuracy of 86%; and OPG-Gee, no false-positive, two false-negative, and 70 correct with an overall accuracy of 97%. Independent of noninvasive test results, 57 symptomatic and three asymptomatic patients were selected for carotid endarterectomy. Of these 60 patients, 55 (92%) had positive preoperative OPG-Gee tracings. Noninvasive testing is a valuable carotid endarterectomy. Although considerable carotid ulceration may be undetected by noninvasive study, it was uncommon in this series.
D002339:Carotid Arteries / Q000601:surgery; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D002533:Cerebral Angiography; D003951:Diagnostic Errors; D004691:Endarterectomy; D005069:Evaluation Studies as Topic; D006801:Humans; D009880:Ophthalmic Artery; D010991:Plethysmography / Q000379:methods*; D011446:Prospective Studies; D014463:Ultrasonography