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Predictive Value in Defining Operable Carotid Artery Disease

Robert W. Barnes, MD; Stanley E. Rittgers, PhD; William W. Putney

Arch Surg. 1982;117(1):52-57.

Abstract
• A prospective study compared the sensitivity, specificity, and predictive value of indirect periorbital Doppler screening and direct carotid Doppler interrogation using real-time sound spectrum analysis to detect operable extracranial carotid occlusive disease. The results of noninvasive studies were compared with independently assessed contrast arteriograms of carotid arteries of patients studied for symptomatic cerebrovascular disease. Periorbital Doppler ultrasound was insensitive to carotid stenosis of less than 75% and did not distinguish operable stenosis from inoperable occlusion of the internal carotid artery. Carotid Doppler spectrum analysis was sensitive to 98% of hemodynamically significant disease and correctly discriminated 77% of carotid occlusions, 96% of stenoses larger than 50% and 70% of stenoses of less than 50%. The predictive value for direct carotid interrogation in identifying carotid occlusion or operable stenosis was 94% and 86%, respectively. Real-time spectrum analysis of direct carotid Doppler signals substantially improves the diagnostic accuracy of noninvasive identification of operable carotid artery disease.

(Arch Surg 1982;117:52-57)

Author Affiliations
From the Noninvasive Peripheral Vascular Laboratories, McGuire Veterans Administration Medical Center (Drs Barnes and Rittgers and Mr Putney); and The Medical College of Virginia, Virginia Commonwealth University (Drs Barnes and Rittgers), Richmond.

Footnotes
Accepted for publication May 12, 1981.

Reprint requests to Box 221, MCV Station, Richmond, VA 23298 (Dr Barnes).

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