MINIMALLY INVASIVE AND NONINVASIVE DIAGNOSIS OF CAROTID-ARTERY OBSTRUCTIVE DISEASE - AN EVALUATION OF SUPRAORBITAL FLUORESCEIN ANGIOGRAPHY AND ULTRASONIC DUPLEX TECHNIQUE

The carotid arteries of twenty-five patients with transient ischaemic attacks, minor stroke or amaurosis fugax were examined by conventional angiography, the ultrasonic duplex technique and supraorbital fluores cein angiography (SOFA). The results of the last two techniques (non-i nvasive and minimally invasive, respectively) were compared with the r esults of angiography. We found that the ultrasonic duplex technique i s highly sensitive and specific for both high and low-grade carotid st enoses while the less costly SOFA can only identify stenoses equal to or more than 75%. However, since tight stenosis has proved to be an in dication for surgical reconstruction, SOFA - or possibly the still sim pler procedure with direct ocular inspection of the supraorbital fluor escence pattern without any recording - would be useful for initial sc reening in smaller units without access to ultrasonic duplex examinati on. In this way potential candidates for surgery can be identified wit hout delay and forwarded to larger units for further supplementary exa minations.