A comparison of angiography with oculopneumoplethysmography in carotid artery disease.

Oculopneumoplethysmography (OPPG) is a non-invasive method for the detection of carotid artery disease. In order to evaluate this method an OPPG test was performed routinely on 220 patients who were suspected of cerebrovascular disease. Sixty of these patients, selected on clinical grounds, also underwent angiography and our report deals with this group of patients. They were subdivided in the light of the angiographic findings and the results of the OPPG tests were compared with those of angiography. In 13 patients with a normal angiogram all but one had a normal OPPG test, indicating a specificity of 93%. Three out of 12 patients with a stenosis of less than 60% had an abnormal OPPG test, reflecting hemodynamic alterations in arteries, shown as mildly stenotic by angiography. Thirty-two out of 35 patients with a stenosis of at least 60% or actual occlusion had an abnormal OPPG test indicating a sensitivity of 91%, which increased to 97% with inclusion of carotid compression findings. The hemodynamic significance of the deviating tests in the latter two groups is discussed. OPPG is an easy and simple method of complementing angiography with hemodynamic data in patients with transient ischemic attacks (TIA's) and cerebrovascular accidents (CVA's). It can also be used to screen patients with asymptomatic bruits or vague neurologic complaints, prior to vascular surgery and to follow patients up after carotid endarterectomy.