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Purpose: Several studies demonstrated feasibility of visual assessment of the Doppler waveform in common femoral artery in a indirect evaluation of aorto-iliac segment. Since adult patients with cardiac diseases often have coexistent arterial pathology, we decided to study, whether echocardiography can be useful in screening for significant aorto-iliac occlusive disease in these patients.Methods: We evaluated 92 patients with abdominal aortic aneurysm or peripheral artery occlusive disease, referred from the vascular surgery department for cardiac evaluation before surgery. At the end of echocardiographic examination, evaluation of flow in the distal external iliac arteries with an echocardiographic probe was performed. Doppler waveform was classified into normal - with early diastolic flow reversal or abnormal - without early diastolic flow reversal. Echocardiographic results were compared in a blinded fashion with reports from computer tomographic angiography.Results: Overall there were 58 iliac segments with significant (≥ 70%) stenosis or occlusion and 126 iliac segments without significant disease on computer tomographic angiography. Abnormal Doppler waveform was found in 56 out of 58 abnormal iliac segments – sensitivity 97%, and normal waveform was found in 106 out of 126 normal iliac segments – specificity 84%. Positive predictive value of abnormal Doppler waveform for significant iliac disease was 74%, and negative predicting value was 98%.Conclusions: Echocardiography can be applied as a good screening method for the detection of significant aorto-iliac occlusive disease.