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) References 1. Barnes RW, Russel HE, Bone GE, et al: Doppler cerebrovascular examination: Improved results with refinement in technique . Stroke 8:468-471, 1977.Crossref 2. Moore WS, Bean B, Burton R, et al: The use of ophthalmosonometry in the diagnosis of carotid artery stenosis . Surgery 82:107-115, 1977. 3. Kartchner MM, McRae LP, Morrison FD: Noninvasive detection and evaluation of carotid occlusive disease . Arch Surg 106:528-535, 1973.Crossref 4. Gee W, Oller DW, Amundsen DG, et al: The asymptomatic carotid bruit and the ocular pneumoplethysmography . Arch Surg 112:1381-1386, 1977.Crossref 5. Gross WS, Verta MJ Jr, van Bellen B, et al: Comparison of noninvasive diagnostic techniques in carotid artery occlusive disease . Surgery 82:271-278, 1977. 6. Machleder HI, Barker WF: Noninvasive methods for evaluation of extracranial cerebrovascular disease . Arch Surg 112:944-946, 1977.Crossref 7. Gee W, Smith CA, Hinson CE, et al: Ocular pneumoplethysmography in carotid disease . Med Instrum 8:244-248, 1974. 8. McDonald PT, Rich NM, Collins GJ Jr, et al: Ocular pneumoplethysmography: Detection of carotid disease. Ann Surg, to be published. 9. Hayes WL: Statistics for Psychologists . New York, Holt, Rinehart, & Winston Inc, 1963, pp 601-603.
Archives of Surgery – American Medical Association
Published: Nov 1, 1978