Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/9297
Title: Preoperative assessment of hand circulation by means of Doppler ultrasonography and the modified Allen test.
Authors: Ruengsakulrach, P;Brooks, Mark;Hare, David L;Gordon, I;Buxton, Brian F
Affiliation: Department of Cardiac Surgery, Austin & Repatriation Medical Centre, the University of Melbourne, Victoria, Australia.
Issue Date: 1-Mar-2001
Citation: The Journal of Thoracic and Cardiovascular Surgery; 121(3): 526-31
Abstract: The aims of this study were as follows: (1) to evaluate Doppler ultrasonography in assessing hand collateral circulation; (2) to define the criteria for an abnormal Doppler ultrasonography dynamic test result; and (3) to validate the modified Allen test.The hand circulation of 71 patients scheduled for coronary artery bypass grafting was assessed by means of the Allen test and Doppler ultrasonography. The flow in the superficial palmar branch of the radial artery, the ulnar artery, and the dorsal digital thumb artery with and without radial artery compression were recorded. Flow patterns in the superficial palmar branch of the radial artery, the ulnar artery, and the dorsal digital thumb artery with radial artery compression were categorized into 4 groups: (1) no flow; (2) decreased flow; (3) reversed flow; and (4) increased flow.Among the 71 hands, 4 (5.6%) had an abnormal Allen test result (>10 seconds). Seven (10.6%) of 66 superficial palmar branches of the radial artery, 3 (4.2%) of 71 ulnar arteries, and 2 (2.8%) of 71 dorsal digital thumb arteries showed no flow with radial artery compression, as measured by Doppler ultrasonography. There were significant differences among the 4 groups (superficial palmar branch of the radial artery: F = 7.0, P <.001; ulnar artery: F = 13.1, P <.001; and dorsal digital thumb artery: F = 8.4, P <.001) for the Allen test. Pairwise comparisons showed that when subjected to an Allen test, category 1 patients (no flow) had significantly longer recovery times compared with the other groups (P <.02 in all cases) for the superficial palmar branch of the radial artery, the ulnar artery, and the dorsal digital thumb artery.Absence of flow in the dorsal digital thumb artery with radial artery compression is considered an absolute contraindication to radial artery harvesting. An increased recovery time with the modified Allen test predicts absence of flow in the dorsal digital thumb artery in Doppler ultrasonographic flow patterns. This demonstrates the validity of the modified Allen test for primary screening.
Internal ID Number: 11241088
URI: http://ahro.austin.org.au/austinjspui/handle/1/9297
DOI: 10.1067/mtc.2001.112468
URL: http://www.ncbi.nlm.nih.gov/pubmed/11241088
Type: Journal Article
Subjects: Aged
Collateral Circulation
Female
Hand.blood supply.ultrasonography
Humans
Male
Middle Aged
Radial Artery.transplantation
Regional Blood Flow
Ultrasonography, Doppler
Appears in Collections:Journal articles

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