The accuracy of the supraorbital Doppler examination in the diagnosis of hemodynamically significant carotid occlusive disease.

The supraorbital Doppler technique was used to study 102 carotid arteries prior to arteriography. A carotid stenosis was defined as being hemodynamically significant if the diameter of the lumen were reduced by more than 50 percent. The Doppler examination gave a false-positive result in only two of the 61 arteries which did not demonstrate significant stenoses. False-negative Doppler results occurred in 22 percent of the 41 significant carotid lesions. The presence or absence of significant carotid lesions were predicted in 96 percent of 67 arteries for which the results of the supraorbital examination and carotid auscultation were in agreement. False-negative results occurred in association with significant ipsilateral external and common carotid stenoses and in the presence of unusually efficient collateral circulation via the circle of Willis. The supraorbital Doppler examination is a valuable technique for the identification of patients with hemodynamically significant carotid stenoses.