Diagnosis of carotid artery stenosis with oculopneumoplethysmography alone and in combination with MRA

Richard M. Elias, John T. Wald, David F. Kallmes

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: The purpose of this study was to assess the accuracy of oculopneumoplethysmography (OPG) for the diagnosis of carotid artery stenosis both alone and in conjunction with carotid magnetic resonance angiography (MRA). Methods: This retrospective study reviewed patients who had undergone both OPG and digital subtraction angiography (DSA, 90 patients, 174 vessels) within two weeks to determine the accuracy of OPG with DSA as the reference standard for the detection of carotid artery stenosis. Three carotid artery stenosis thresholds (≥50%, ≥70%, ≥80%) were analyzed. The accuracy of the combination of OPG and MRA was analyzed in a subset of patients who underwent OPG and MRA and DSA (53 patients, 94 vessels). Results: The sensitivity and negative predictive value of OPG increased with higher-degree carotid artery stenoses, and for lesions ≥ 80%, these values were 85.3% and 94.2%, respectively. Specificity and positive predictive values were lower at all thresholds, and were 72.9% and 49.3%, respectively, at the ≥80% stenosis threshold. When OPG and MRA were concordant, the sensitivity and specificity for carotid artery stenoses ≥ 80% were 91.0% and 97.8%, respectively. OPG correctly identified 71.4% of false-positive and 80.0% of false-negative magnetic resonance angiographies for that degree of carotid artery stenosis. Conclusion: OPG appears to be an accurate rule-out test for hemodynamically significant carotid artery stenosis. OPG augments the accuracy of MRA for detection of carotid artery disease.

Original languageEnglish (US)
Pages (from-to)631-639
Number of pages9
JournalVascular health and risk management
Volume8
Issue number1
DOIs
StatePublished - Dec 1 2012

Keywords

  • Carotid artery stenosis
  • Diagnosis
  • Magnetic resonance angiography
  • Oculopneumoplethysmography
  • Stroke

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hematology
  • Public Health, Environmental and Occupational Health
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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