COMPARATIVE-STUDY OF DUPLEX SCANNING AND ANGIOGRAPHY IN CAROTID DISEASE

The increasing accurary of duplex scanning and the morbidity linked to angiography have led some authors to discard the latter when explorin g patients with severe carotid lesions. In order to fully define the r espective information obtained by these two explorations and to determ ine their impact on therapeutic decisions, were examined the file of 1 22 patients. The comparative analysis of preoperative color duplex sca nning and angiographic results, the latter used as a reference, showed a sensitivity of 97 % and a specificity of 57 %, concerning the abili ty to detect a significant carotid artery stenosis. On the other hand, color duplex scan and angiography had the same accuracy to screen the presence of an ulceration, but could only detect two third of the ulc erations observed on pathologic examination of 94 surgically-treated p atients. At last, angiography was more reliable in detecting a carotid excess of length (p < 0.001), in the identification of internal carot id thrombosis and of dissection on dysplasic arteries. In conclusion, we propose a selective indication of angiography in case of suspicion of proximal periaortic arterial lesions, of complications on dysplasic arteries, of detection of pre-thrombotic carotid lesions and in order to confirm the existence of significant stenosis in asymptomatic pati ents.