Accuracy of color Doppler flow mapping for evaluation of the severity of femoropopliteal arterial disease: a prospective study.

The usefulness of color Doppler flow mapping for estimating the severity of femoropopliteal lesions was compared with that of angiography in 35 patients (70 extremities). Sonography depicted significant (greater than 40% luminal narrowing) arterial lesions in 45 of 47 lower extremities in which such lesions were present (sensitivity, 0.96 [95% confidence limits; 0.86, 0.99]). The absence of significant segmental stenosis or occlusion was confirmed in 15 of the 23 normal extremities (specificity, 0.65 [0.45, 0.81]). Occlusions amenable to bypass surgery were correctly predicted in 25 of 26 (sensitivity, 0.96 [0.81, 0.99]) and were excluded in 41 of 44 extremities (specificity, 0.93 [0.82, 0.98]). Lesions amenable to angioplasty were detected in 16 of 21 instances, with overestimation of severity in three lesions that were judged suitable for bypass surgery; two lesions were missed. Preangiographic screening with color Doppler flow mapping is an accurate method for predicting the presence of femoropopliteal artery occlusions amenable to bypass surgery. It is also a sensitive method for predicting the presence of peripheral arterial disease.