Assessment of aortoiliac disease using hemodynamic measures

To study the role of accurate hemodynamic assessment of aortoiliac disease, intra-arterial pressure measurements of 100 aortoiliac segments were compared with Doppler velocity waveform analysis and contrast arteriography. By applying the statistic kappa, we assessed the degree of agreement among the three methods corrected for chance. The agreement between pressure measurements and contrast arteriography provided a kappa of 0.41, as did the agreement between pressure measurements and velocity waveform analysis. Our results indicate that contrast arteriography and Doppler studies underestimate hemodynamically significant aortoiliac disease. Since the correlation is so poor, it is essential to use intra-arterial pressure measurements in every patient who is a candidate for surgery.