Key result
Direct carotid Doppler yields ~94% accuracy for detecting stenosis, outperforming oculoplethysmography and periorbital sonography.
Why the study?
Noninvasive evaluation methods for carotid artery disease vary in accuracy, and a prospective comparison of three techniques was needed.
Does direct scanning with a color coded Doppler imaging system improve accuracy for detecting carotid artery stenosis compared to oculoplethysmography-carotid phonoangiography and periorbital directional Doppler sonography in patients evaluated for possible carotid insufficiency?
Observational (n=216)
Does direct scanning with a color coded Doppler imaging system improve accuracy for detecting carotid artery stenosis compared to oculoplethysmography-carotid phonoangiography and periorbital directional Doppler sonography in patients evaluated for possible carotid insufficiency?
Direct Doppler examination of the carotid bifurcation is superior to oculoplethysmography-carotid phonoangiography and periorbital directional Doppler sonography for detecting significant carotid artery stenosis.
May support direct Doppler over legacy methods for carotid stenosis detection; leaves open prospective validation before practice change.
Oculoplethysmography-carotid phonoangiography and periorbital directional Doppler sonography are two techniques widely used in the noninvasive evaluation of possible carotid artery disease. Recent advances with sonographic Doppler devices now permit measurement of blood velocities in the extracranial carotid arteries by direct scanning with a color coded Doppler imaging system. A prospective study involving 216 patients being evaluated for possible carotid insufficiency was carried out to compare the results obtained with these three methods. With stenosis 65% or greater at angiography, the accuracy of the Doppler imaging system was 94%, that of oculoplethysmography-carotid phonoangiography was 84%, and that of periorbital directional Doppler sonography was 80%. These results demonstrate that direct Doppler examination of the carotid bifurcation is superior to either of the other two techniques for the detection of carotid artery stenosis.
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O’Leary et al. (1981) conducted an observational in possible carotid insufficiency (n=216). Color coded Doppler imaging system vs. Oculoplethysmography-carotid phonoangiography and periorbital directional Doppler sonography was evaluated on Accuracy for detecting stenosis 65% or greater at angiography. Direct Doppler imaging of the carotid bifurcation demonstrated 94% accuracy for detecting ≥65% stenosis, superior to oculoplethysmography (84%) and periorbital Doppler sonography (80%).
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