Mj. Boyle et al., ACCURACY CF DUPLEX VERSUS ANGIOGRAPHY IN PATIENTS UNDERGOING CAROTID SURGERY, Journal of the Royal Society of Medicine, 88(1), 1995, pp. 20-23
The operative findings of 23 carotid arteries were compared with pre-o
perative duplex scans and angiography. Both duplex and angiography had
a high degree of accuracy in detecting haemodynamically significant l
esions of 50-99% (88 and 92%, respectively). Their accuracy, however,
in correctly predicting the grade of stenosis was significantly lower;
30 and 48%, respectively (P<0.001). They each exhibited an accuracy o
f 70% and 78%, respectively, in the detection of ulceration. Overall,
both duplex and angiography displayed an accuracy of 87% in indicating
the proper management course. The combination of bath investigations
increased this accuracy to 94.6%. In severely stenotic lesions, duplex
to rule out occlusion was not reliable. On statistical analysis, ther
e was no difference between duplex and angiography in predicting haemo
dynamically significant lesions of 50-99%, estimating the grade of ste
nosis, the detection of ulceration, or indicating the proper managemen
t course. In most situations, duplex alone equalled the accuracy of an
giography in the pre-operative assessment of patients for carotid surg
ery. For stenotic lesions of >90%, however, we recommend supplemental
angiography to rule out occlusion.