Noninvasive Detection and Evaluation of Carotid Occlusive Disease

Abstract

Two complementary noninvasive techniques, carotid phonoangiography and oculoplethysmography, were used to evaluate 360 carotid arteries in 208 patients to determine their diagnostic accuracy based on arteriography. A composite diagnostic accuracy of 86% by phonoangiography and 91% by oculoplethysmography was achieved. Intraoperative flow measurements from 69 operative procedures in 66 patients were used to evaluate the ability of arteriography, phonoangiography, and oculoplethysmography to assess the hemodynamic significance of a given carotid occlusive lesion. Arteriography had a composite accuracy of 86% (10% false positives and 4% false negatives). This recognizes the bias introduced by surgical selection being based on arteriography. Phonoangiography gave 72% accurate interpretations (9% false positives and 19% false negatives). Oculoplethysmography was more accurate with 87% correct interpretations (3% false positives and 10% false negatives). No contraindications or significant complications were encountered with these methods.