Duplex ultrasound in patients with suspected aorto-iliac occlusive disease

Duplex ultrasound scanning was used to localise and classify aorto-iliac occlusive disease. The study included 76 consecutive examinations of 73 patients with signs suggestive of proximal occlusive disease either by history or from traditional non-invasive laboratory investigation. Duplex ultrasound scanning indicated the presence of significant proximal occlusive disease in 70/101 limbs with suspected aorto-iliac disease. In total, 383/393 proximal arterial segments were assessed. A complete evaluation of the aorto-iliac region was possible in 91% of the patients. Duplex scanning was superior to oscillometric amplitude measurements and to CW Doppler examination, especially in patients with concomitant disease of the proximal superficial and deep femoral arteries. Duplex classification of stenoses correlated well with angiographic results obtained in 60 limbs with exact agreement in 194/211 (92%) arterial segments. Three of the patients with disparity between ultrasonography and angiography were investigated with intraarterial pressure measurements demonstrating that these lesions were underestimated by angiography. We conclude that Duplex ultrasound is feasible and accurate in detecting and grading lesions in the aorto-iliac region. This method provides important clinically useful haemodynamic information non-invasively in patients with suspected aorto-iliac occlusive disease.