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Use in Detection of Carotid Disease: A Prospective Clinical Study

Lt Col Paul T. McDonald, MC, USA; Col Norman M. Rich, MC, USA; Lt Col George J. Collins, MC, USA; Lt Col Charles A. Andersen, MC, USA; Maj Louis Kozloff, MC, USA

Arch Surg. 1978;113(11):1341-1349.

Abstract
• To determine the comparative accuracy 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 adjunct in identifying patients who ultimately require carotid endarterectomy. Although considerable carotid ulceration may be undetected by noninvasive study, it was uncommon in this series.

(Arch Surg 113:1341-1349, 1978)

Author Affiliations
From the Peripheral Vascular Surgery Service, Department of Surgery, Walter Reed Army Medical Center, Washington, DC, and the Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Md.

Footnotes
Accepted for publication July 17, 1978.

Read before the 26th annual meeting of the International Cardiovascular Society, Los Angeles, June 24, 1978.

The opinion or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Peripheral Vascular Surgery Service, Walter Reed Army Medical Center, Washington, DC 20012 (Dr McDonald).

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