Atraumatic detection of occlusive vascular disease in carotid and subclavian arteries by opacity pulse propagation techniques

Opacity pulse propagation measurement and thermometry in the evaluation of carotid occlusive vascular disease: correlations with angiography

A correlative study of four-vessel angiography with measurements of opacity pulse propagation times and skin temperatures over the medial supraorbital areas of the forehead was carried out in 46 patients. Differences in propagation times of greater than 12 milliseconds and/or in thermometric measurements of 1 °F or more were always associated with angiographically demonstrable carotid occlusive disease. In patients with positive angiographical findings, prolongation of pulse propagation time was associated with lower skin temperature when the latter occurred. Test results indicated abnormality in six of seven patients with bilateral carotid occlusive disease. By these methods, unilateral occlusive lesions of 30% to 50% of the vascular lumen were detected in three of five instances where such lesions occurred; occlusive lesions greater than this degree were detected in 15 of 18 patients. The tests identified as "normal" 18 of 23 patients whose four-vessel angiograms were either totally unremarkable or showed lesions compromising less than 30% of the carotid lumen. Combination of these screening tests is more useful than either test employed alone and may be helpful in clinical evaluation of patients with cerebrovascular disease.