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Abstract:The Detection of Carotid Artery Obstruction: A Correlation With A rteriography• Intravenous radioisotope arteriography, carotid compression ocular plethysmography, and supraorbital Doppler studies were more accurate than ophthalmodynamometry in the detection of the presence or absence of carotid artery obstruction in 35 patients. Abnormal results were present in patients with carotid obstruction who did not have a carotid bruit.The isotope method provides information about relative blood flow through the two carotid arteries. Ocular plethysmography and supraorbital Doppler studies provide information about collateral circulatory pathways in patients with carotid obstruction.Currently, they are most useful clinically in patients who are erroneously thought to have only intracranial vascular disease since abnormal results suggest an extracranial carotid lesion. These methods will not reveal abnormalities in patients with small, ulcerated carotid plaques which are a source of embolic material but which are not decreasing carotid blood pressure and flow. ADDITIONAL KEY WORDS extracranial arterial occlusion ocular plethysmography Doppler technique intravenous radioisotope arteriography ophthalmodynamometry• Atherosclerotic disease in the extracranial portion of the carotid artery is a frequent yet potentially preventable cause of stroke.1 Cerebral symptoms and infarction appear to be associated with severe stenosis or complete obstruction of the carotid artery, with a resultant decrease in carotid blood flow, and with emboli from ulcerated carotid plaques, even when carotid blood flow is not diminished. 2Recognition of carotid disorders before cerebral infarction occurs is sometimes difficult. Transient ischemic attacks in the distribu-

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