Abdominal aortic Doppler waveform in patients with aorto-iliac disease.
OBJECTIVE
The mid-systolic deceleration (notch) in the proximal descending aortic Doppler waveform was reported to be common in patients with aorto-iliac disease. However, evaluation of the descending aorta is limited to echocardiography and may be technically difficult. Therefore, we decided to check whether similar Doppler flow disturbance can be found in abdominal aorta, which is easily evaluated in wider range of patients undergoing general abdominal and vascular ultrasound, as well as echocardiography.


METHODS
We evaluated 115 consecutive symptomatic patients with severe peripheral artery disease admitted for vascular surgery, and 60 controls. The presence or absence of the mid-systolic deceleration in the Doppler waveform was evaluated retrospectively, by the single echocardiographer blinded to the localisation of the arterial occlusion or stenosis.


RESULTS
The mid-systolic notch in the proximal abdominal aorta was present in 58 of 71 patients (82%) with significant aorto-iliac disease, seven of 44 (16%) patients with occlusion or significant stenosis distally to the external iliac artery (P < 0.001) and in none of the patients from the control group. Sensitivity, specificity and positive predictive value of the mid-systolic notch in the abdominal aortic Doppler waveform in the detection of aorto-iliac disease in patients with peripheral artery disease were 82%, 84% and 89%, respectively.


CONCLUSIONS
The mid-systolic deceleration (notch) in the proximal abdominal Doppler waveform is a simple ultrasonographic marker of significant aorto-iliac disease.
Styczynski
G
G
Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland. grzegorz.styczynski@wum.edu.pl
Szmigielski
C
C
Leszczynski
J
J
Kuch-Wocial
A
A
Szulc
M
M
D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler