Supraorbital Doppler evaluation in vascular surgery

Directional Doppler examination of the supraorbital vessels is an effective, noninvasive method of evaluating patency of the internal carotid artery. In the presence of occlusive disease in the internal carotid artery, flow in the superficial temporal and frontal artery is reversed so that blood flows in a retrograde fashion into the orbit, providing valuable collateral circulation to the brain. Using these basic anatomical and physiological facts, the direction of arterial flow in the supraorbital vessels and the response to compression of the superficial temporal and facial arteries were measured with the directional Doppler. Evaluation of 125 carotid arteries in 63 patients by both arteriography and Doppler examination established an overall accuracy of 87 percent by the Doppler supraorbital test. This study demonstrated the value of carotid Doppler examination in the evaluation of extracranial cerebral circulation.