[Diagnosis of extracranial carotid diseases. Doppler-echo flow and transvenous digital subtraction angiography].

Doppler-echo flow was measured in the assessment of 3608 carotid arterial systems (common, internal and external carotid arteries on one side). Conventional carotid angiography was performed in 156 cases, 363 were examined by digital subtraction angiography (DSA). All three methods were employed for 32 carotid systems. It was demonstrated that the accuracy of the Doppler-echo flow method depends on the experience of the examiner. In the hands of the experienced, accurate diagnosis with regard to "haemodynamic effective obstruction" was 96% and for "no haemodynamically effective obstruction" 98%. Among beginners the corresponding results were 87 and 93%, respectively. DAS was a very low-risk procedure. Directly occurring cerebrovascular complications during manipulation were not observed among 1,000 procedures. The results agreed in 88% of cases examined by the Doppler-echo flow method, so that in most cases it is possible to avoid arterial angiography with its higher risks. Analysis of 32 cases, in which there was additional arterial angiography, indicates that there may be some false-positive and false-negative results with DSA. If the findings do not agree, arterial angiography is still necessary.