The echo-Doppler (duplex) system for the detection of vertebral artery occlusive disease: comparison with angiography.

The reliability of the echo-Doppler (duplex) system for the visualization of the vertebral arteries was evaluated in 304 patients, in which 588 vertebral arteries had been investigated. Of these, 545 (92.69 per cent) arteries, either normal or diseased, were successfully visualized. However, the origin of the vertebral artery from the subclavian artery was localized in only 354 vessels (60 per cent of those visualized). Angiography was available for comparison in 33 arteries. The overall accuracy and the sensitivity of the duplex were 63.64 per cent and 38.46 per cent, respectively; they attained 86.67 per cent and 83.33 per cent in the vertebral arteries visualized from their origin, (a site early and most commonly involved by the atherosclerotic process). As the vertebral arteries can be visualized with a 92 per cent success rate, their examination should become a routine part of the duplex cerebrovascular study. In order to accurately detect diseased vertebral arteries, their origin from the subclavian artery should be localized.