The Role of the Oculopneumoplethysmography in Detecting Postendarterectomy Carotid Stenosis or Thrombosis.

The oculopneumoplethysmography has been a well established tool in the diagnosis of significant carotid artery stenosis; however, very few articles have studied the role of the OPG/Gee in detecting the postendarterectomy stenosis or thrombosis. The purpose of this article is to study that role. Eighty-two patients who had carotid endarterectomy and postoperative OPG/Gee were reviewed and compared with carotid arteriograms. Sixteen of these had bilateral and 66 had unilateral carotid endarterectomy. Seventy-nine of these patients had angiograms and three were explored. The total arteries studied were 98. Thirteen of these oculopneumoplethysmograms were done in the recovery room and the rest a few days to three years later. A carotid stenosis of 50% or more in diameter was considered significant. There were 10 positive oculopneumoplethysmograms, nine of which were confirmed by angiograms; i.e., 10.0% false positive rate. There were also three positive oculopneumoplethysmograms which were explored in surgery and found to be thrombosed; i.e., a total of 13 positive oculopneumoplethysmograms, 12 of which were confirmed which made the real false positive rate 7.7%. Eleven patients had positive arteriograms, nine of which had positive oculopneumoplethysmograms; i.e., 81.8% diagnostic sensitivity (9/11). Eighty-four arteries were considered normal by arteriogram (11 of which had insignificant stenosis), 83 of these had negative oculopneumoplethysmograms; i.e., 98.8% diagnostic specificity (83/84). The false negative rate was 2.4% (2/85). The overall accuracy rate was 96.8% (92/95). If the three explored arteries were added, the overall accuracy rate would be 96.9% (95/98). To conclude, the OPG/Gee is a valuable tool in detecting immediate postendarterectomy thrombosis or recurrent stenosis. The oculopneumoplethysmography has been well established as a tool in detecting significant carotid artery stenosis. However, very few articles studied the value of the oculopneumoplethysmography in detecting the postendarterectomy stenosis, whether immediate postoperative occlusion or recurrent carotid artery stenosis. The purpose of this paper is to study the value of the OPG/Gee in detecting the postoperative carotid stenosis or occlusion. [ABSTRACT FROM AUTHOR]