The asymptomatic carotid bruit and the ocular pneumoplethysmography.

Patients with asymptomatic carotid bruits require some noninvasive method for detecting which would benefit from angiography and possible prophylactic operative repair of the suspected atherosclerotic lesion. This report describes the use of the ocular pneumoplethysmograph (OPG) in this regard. Data for establishing OPG criteria of significant carotid stenosis were derived from studies in symptomatic patients who had also undergone angiography. In this review, the OPG demonstrated an accuracy of 91.6% in detecting at least a 75% diameter stenosis. The OPG criteria were applied to 116 patients with asymptomatic carotid bruits. Forty two of the 116 patients fulfilled at least one of the four criteria for angiography. In 38 of the 40 patients who underwent angiography, the OPG findings were confirmed, for an accuracy of 95%. Twenty-two patients underwent 27 operations, without morbidity or mortality.