Journal of Ultrasound in Medicine, Vol 16, Issue 8 525-528, Copyright © 1997 by American Institute of Ultrasound in Medicine
Doppler spectrum analysis versus direct femoral artery pressure measurement for rapid assessment of aortoiliac obstruction
J. A. van der Vliet, W. N. van Asten, J. H. Haenen, A. P. Boll and F. G. Buskens
Department of Surgery, St. Radboud University Hospital, Nijmegen, The Netherlands.
Adequate patient selection is required to limit the clinical workload and
improve the cost-effectiveness of noninvasive hemodynamic evaluation of the
aortoiliac system. In a prospective blinded fashion the traditional
invasive technique of direct femoral artery pressure measurements and the
computerized Doppler spectrum analysis of blood flow velocities in the
common femoral artery were studied. Both tests for rapid assessment of
aortoiliac obstruction were compared with duplex ultrasonographic imaging,
using a peak systolic velocity ratio of 2.5 to demonstrate stenoses of 50%
or more. In a series of 17 consecutive patients (34 aortoiliac segments)
with suspected aortoiliac obstructive disease, a good level of agreement
(kappa = 0.6) was found for both methods when compared with duplex
scanning. Analysis of deviations from the duplex registrations indicated an
overestimation of the pathologic cases using femoral artery pressure
measurements and an underestimation using Doppler spectrum analysis of
blood flow velocities in the common femoral artery. Both methods were well
tolerated, but femoral artery pressure measurements had a higher technical
failure rate. Because of its noninvasive character and its feasibility the
Doppler technique is preferred for the selection of patients for more
extensive duplex sonographic investigation.
