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October 1980

Oculoplethysmography/ Carotid Phonoangiography: Its Value as a Screening Test in Patients With Suspected Carotid Artery Stenosis

Author Affiliations

From the Department of Cardiovascular and Thoracic Surgery (Drs Keagy, Pharr, and Bowes), and the Peripheral Vascular Laboratory (Mr Thomas), Geisinger Medical Center, Danville, Pa.

Arch Surg. 1980;115(10):1199-1202. doi:10.1001/archsurg.1980.01380100045010

• A review of 291 carotid arteries that were subjected to both oculoplethysmography/carotid phonoangiography (OPG/CPA) and arteriography showed that although 84% of the vessels that were narrowed less than 40% were properly categorized by the noninvasive test, there was poor grading ability for lesions 40% or greater, and an unacceptably high (40%) false-negative rate for marked carotid stenoses. This has been confirmed by others. Analysis of a 15-item questionnaire that was returned by 12 clinicians showed an unwarranted reliance on the OPG/CPA as a screening test in those patients without transient ischemic attacks. A large majority of responding physicians favored endarterectomy in asymptomatic patients with lesions greater than 70%, and the use of OPG/CPA prevented a substantial number of affected individuals from undergoing angiography and subsequent corrective surgery.

(Arch Surg 115:1199-1202, 1980)