Oculoplethysmography/carotid phonoangiography: its value as a screening test in patients with suspected carotid artery stenosis.

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.