Noninvasive localization of arterial occlusive disease: A comparison of segmental Doppler pressures and arterial duplex mapping

Purpose: The purpose of this study was to compare the abilities of arterial duplex mapping and segmental Doppler pressures to noninvasively localize hemodynamically significant lower extremity arterial occlusive disease. Methods: After angiographic controls were instituted, arterial duplex mapping and segmental Doppler pressures were blindly compared for their ability to localize a high-grade (50% to 100%) stenosis to the iliac or common femoral arteries, the superficial femoral artery, or the popliteal artery in 151 lower extremities from 79 patients. Results: Rates of sensitivity and specificity of arterial duplex mapping for identifying a high-grade stenosis at the three arterial levels were 88% and 97%, 95% and 100%, and 78% and 99%, respectively. Those for segmental Doppler pressures were 59% and 86%, 73% and 80%, and 48% and 53%, respectively. There was complete agreement between arterial duplex mapping and angiography in 82% of the limbs studied and between segmental pressures and angiography in 34% of the limbs (p < 0.0001). The presence of diabetes, kidney failure, or previous vascular surgery in the limb studied did not affect the accuracy of either test. Conclusion: Arterial duplex mapping is far superior to segmental Doppler pressures for localization of high-grade angiographic lesions from the iliac to the popliteal arteries.