Vascular communications of the hand in patients being considered for transradial coronary angiography: is the Allen's test accurate?
The purpose of this study was to assess the accuracy of the Allen's test (AT) in predicting hand ischemia in patients undergoing transradial coronary angiography. Patients with poor vascular communications between the radial artery (RA) and ulnar artery (UA), as indicated by an abnormal AT, are...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2005-12, Vol.46 (11), p.2013-2017 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Greenwood, Michael J Della-Siega, Anthony J Fretz, Eric B Kinloch, David Klinke, Peter Mildenberger, Richard Williams, Malcolm B Hilton, David |
| description | The purpose of this study was to assess the accuracy of the Allen's test (AT) in predicting hand ischemia in patients undergoing transradial coronary angiography.
Patients with poor vascular communications between the radial artery (RA) and ulnar artery (UA), as indicated by an abnormal AT, are usually excluded from transradial coronary angiography to avoid ischemic hand complications.
Over a four-month period, patients undergoing coronary angiography were screened for AT time. Circulation in the RA, UA, principal artery of the thumb (PAT), and thumb capillary lactate were measured before and after 30 min of RA occlusion.
Fifty-five patients were studied (20 normal, 15 intermediate, 20 abnormal). Three patients with an abnormal AT were excluded, owing to absence of detectible flow in the distal UA. Patients with an abnormal AT were all men, had a larger RA (3.4 vs. 2.8 mm; p |
| doi_str_mv | 10.1016/j.jacc.2005.07.058 |
| format | Article |
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Patients with poor vascular communications between the radial artery (RA) and ulnar artery (UA), as indicated by an abnormal AT, are usually excluded from transradial coronary angiography to avoid ischemic hand complications.
Over a four-month period, patients undergoing coronary angiography were screened for AT time. Circulation in the RA, UA, principal artery of the thumb (PAT), and thumb capillary lactate were measured before and after 30 min of RA occlusion.
Fifty-five patients were studied (20 normal, 15 intermediate, 20 abnormal). Three patients with an abnormal AT were excluded, owing to absence of detectible flow in the distal UA. Patients with an abnormal AT were all men, had a larger RA (3.4 vs. 2.8 mm; p <0.001), and smaller UA (1.9 vs. 2.5 mm; p <0.001), compared with patients with a normal AT. After 30 min of RA occlusion in patients with abnormal AT, blood flow to the PAT improved (3.2 to 7.7 cm/s; p <0.001) yet remained reduced relative to patients with normal AT (7.7 vs. 21.4 cm/s; p <0.001. Thumb capillary lactate was elevated in patients with an abnormal AT (2.0 vs. 1.5 mmol/l; p = 0.019).
After 30 min of RA occlusion, patients with an abnormal AT showed significantly reduced blood flow to the thumb and increased thumb capillary lactate (compared with patients with a normal AT) suggestive of ischemia. Transradial cardiac catheterization should not be performed in patients with an abnormal AT.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2005.07.058</identifier><identifier>PMID: 16325034</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Aged ; Blood Flow Velocity ; Cardiology ; Collateral Circulation ; Constriction ; Female ; Fingers & toes ; Hand - blood supply ; Humans ; Intubation ; Lactic Acid - blood ; Male ; Medical imaging ; Middle Aged ; Predictive Value of Tests ; Radial Artery - physiology ; Regional Blood Flow ; Statistical analysis ; Thumb - blood supply ; Thumb - diagnostic imaging ; Ulnar Artery - physiology ; Ultrasonography, Doppler, Color ; Variance analysis ; Veins & arteries</subject><ispartof>Journal of the American College of Cardiology, 2005-12, Vol.46 (11), p.2013-2017</ispartof><rights>Copyright Elsevier Limited Dec 6, 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16325034$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Greenwood, Michael J</creatorcontrib><creatorcontrib>Della-Siega, Anthony J</creatorcontrib><creatorcontrib>Fretz, Eric B</creatorcontrib><creatorcontrib>Kinloch, David</creatorcontrib><creatorcontrib>Klinke, Peter</creatorcontrib><creatorcontrib>Mildenberger, Richard</creatorcontrib><creatorcontrib>Williams, Malcolm B</creatorcontrib><creatorcontrib>Hilton, David</creatorcontrib><title>Vascular communications of the hand in patients being considered for transradial coronary angiography: is the Allen's test accurate?</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>The purpose of this study was to assess the accuracy of the Allen's test (AT) in predicting hand ischemia in patients undergoing transradial coronary angiography.
Patients with poor vascular communications between the radial artery (RA) and ulnar artery (UA), as indicated by an abnormal AT, are usually excluded from transradial coronary angiography to avoid ischemic hand complications.
Over a four-month period, patients undergoing coronary angiography were screened for AT time. Circulation in the RA, UA, principal artery of the thumb (PAT), and thumb capillary lactate were measured before and after 30 min of RA occlusion.
Fifty-five patients were studied (20 normal, 15 intermediate, 20 abnormal). Three patients with an abnormal AT were excluded, owing to absence of detectible flow in the distal UA. Patients with an abnormal AT were all men, had a larger RA (3.4 vs. 2.8 mm; p <0.001), and smaller UA (1.9 vs. 2.5 mm; p <0.001), compared with patients with a normal AT. After 30 min of RA occlusion in patients with abnormal AT, blood flow to the PAT improved (3.2 to 7.7 cm/s; p <0.001) yet remained reduced relative to patients with normal AT (7.7 vs. 21.4 cm/s; p <0.001. Thumb capillary lactate was elevated in patients with an abnormal AT (2.0 vs. 1.5 mmol/l; p = 0.019).
After 30 min of RA occlusion, patients with an abnormal AT showed significantly reduced blood flow to the thumb and increased thumb capillary lactate (compared with patients with a normal AT) suggestive of ischemia. Transradial cardiac catheterization should not be performed in patients with an abnormal AT.</description><subject>Aged</subject><subject>Blood Flow Velocity</subject><subject>Cardiology</subject><subject>Collateral Circulation</subject><subject>Constriction</subject><subject>Female</subject><subject>Fingers & toes</subject><subject>Hand - blood supply</subject><subject>Humans</subject><subject>Intubation</subject><subject>Lactic Acid - blood</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Radial Artery - physiology</subject><subject>Regional Blood Flow</subject><subject>Statistical analysis</subject><subject>Thumb - blood supply</subject><subject>Thumb - diagnostic imaging</subject><subject>Ulnar Artery - physiology</subject><subject>Ultrasonography, Doppler, Color</subject><subject>Variance analysis</subject><subject>Veins & arteries</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkDtP5TAQhS0EggvLH6BAlpCWKlk7jh-hQQgtDwlpG9g2msSTe32V2Bc7Kej3h6_Fo6Ga0cynM-cMIWeclZxx9WtbbqHvy4oxWTJdMmn2yIpLaQohG71PVkwLWXDW6CNynNKWMaYMbw7JEVeikkzUK_LvL6R-GSHSPkzT4l0Psws-0TDQeYN0A95S5-kuj9HPiXbo_DrDPjmLES0dQqRzBJ8iWAdjXsXgIb5R8GsX1hF2m7cr6tK73M04or_MPaaZZvNLhBmvf5CDAcaEp5_1hLzc_X6-fSie_tw_3t48FZtKi7nAWvRd03RcW9S8qVEY2QGqTlgF0lYwyBywGrgVSsiKa6yNwLq2XDPTDL04IT8_dHcxvC7ZQju51OM4gsewpFYZIxupeAYvvoHbsESfvbU83-BKaW4ydf5JLd2Ett1FN-Xg7dd3xX--T36r</recordid><startdate>20051206</startdate><enddate>20051206</enddate><creator>Greenwood, Michael J</creator><creator>Della-Siega, Anthony J</creator><creator>Fretz, Eric B</creator><creator>Kinloch, David</creator><creator>Klinke, Peter</creator><creator>Mildenberger, Richard</creator><creator>Williams, Malcolm B</creator><creator>Hilton, David</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20051206</creationdate><title>Vascular communications of the hand in patients being considered for transradial coronary angiography: is the Allen's test accurate?</title><author>Greenwood, Michael J ; Della-Siega, Anthony J ; Fretz, Eric B ; Kinloch, David ; Klinke, Peter ; Mildenberger, Richard ; Williams, Malcolm B ; Hilton, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h273t-e43cb99b17de7194e385bae6b3d6a5d2af50682f1d3635217e483e44d17089fc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Blood Flow Velocity</topic><topic>Cardiology</topic><topic>Collateral Circulation</topic><topic>Constriction</topic><topic>Female</topic><topic>Fingers & toes</topic><topic>Hand - blood supply</topic><topic>Humans</topic><topic>Intubation</topic><topic>Lactic Acid - blood</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Radial Artery - physiology</topic><topic>Regional Blood Flow</topic><topic>Statistical analysis</topic><topic>Thumb - blood supply</topic><topic>Thumb - diagnostic imaging</topic><topic>Ulnar Artery - physiology</topic><topic>Ultrasonography, Doppler, Color</topic><topic>Variance analysis</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Greenwood, Michael J</creatorcontrib><creatorcontrib>Della-Siega, Anthony J</creatorcontrib><creatorcontrib>Fretz, Eric B</creatorcontrib><creatorcontrib>Kinloch, David</creatorcontrib><creatorcontrib>Klinke, Peter</creatorcontrib><creatorcontrib>Mildenberger, Richard</creatorcontrib><creatorcontrib>Williams, Malcolm B</creatorcontrib><creatorcontrib>Hilton, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Greenwood, Michael J</au><au>Della-Siega, Anthony J</au><au>Fretz, Eric B</au><au>Kinloch, David</au><au>Klinke, Peter</au><au>Mildenberger, Richard</au><au>Williams, Malcolm B</au><au>Hilton, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascular communications of the hand in patients being considered for transradial coronary angiography: is the Allen's test accurate?</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2005-12-06</date><risdate>2005</risdate><volume>46</volume><issue>11</issue><spage>2013</spage><epage>2017</epage><pages>2013-2017</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><abstract>The purpose of this study was to assess the accuracy of the Allen's test (AT) in predicting hand ischemia in patients undergoing transradial coronary angiography.
Patients with poor vascular communications between the radial artery (RA) and ulnar artery (UA), as indicated by an abnormal AT, are usually excluded from transradial coronary angiography to avoid ischemic hand complications.
Over a four-month period, patients undergoing coronary angiography were screened for AT time. Circulation in the RA, UA, principal artery of the thumb (PAT), and thumb capillary lactate were measured before and after 30 min of RA occlusion.
Fifty-five patients were studied (20 normal, 15 intermediate, 20 abnormal). Three patients with an abnormal AT were excluded, owing to absence of detectible flow in the distal UA. Patients with an abnormal AT were all men, had a larger RA (3.4 vs. 2.8 mm; p <0.001), and smaller UA (1.9 vs. 2.5 mm; p <0.001), compared with patients with a normal AT. After 30 min of RA occlusion in patients with abnormal AT, blood flow to the PAT improved (3.2 to 7.7 cm/s; p <0.001) yet remained reduced relative to patients with normal AT (7.7 vs. 21.4 cm/s; p <0.001. Thumb capillary lactate was elevated in patients with an abnormal AT (2.0 vs. 1.5 mmol/l; p = 0.019).
After 30 min of RA occlusion, patients with an abnormal AT showed significantly reduced blood flow to the thumb and increased thumb capillary lactate (compared with patients with a normal AT) suggestive of ischemia. Transradial cardiac catheterization should not be performed in patients with an abnormal AT.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>16325034</pmid><doi>10.1016/j.jacc.2005.07.058</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Blood Flow Velocity Cardiology Collateral Circulation Constriction Female Fingers & toes Hand - blood supply Humans Intubation Lactic Acid - blood Male Medical imaging Middle Aged Predictive Value of Tests Radial Artery - physiology Regional Blood Flow Statistical analysis Thumb - blood supply Thumb - diagnostic imaging Ulnar Artery - physiology Ultrasonography, Doppler, Color Variance analysis Veins & arteries |
| title | Vascular communications of the hand in patients being considered for transradial coronary angiography: is the Allen's test accurate? |
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