The Allen test is a good and valid screening test for the circulation of the hand. If the Allen test is negative it is safe to harvest the radial artery. If it is positive further examinations are needed to ensure safe harvesting of the radial artery.
Since radial artery is preferably harvested from a non-dominant hand, our aim was to study whether there are contraindications for radial artery harvest in the dominant hand if the radial artery of the other hand is not suitable for harvesting. Thirty-three patients scheduled to coronary artery bypass grafting with contraindication for radial artery harvest in the non-dominant hand underwent Allen test, upper arm Doppler ultrasonography and digital pletysmography. In ultrasonography, both anatomical and circulatory measurements were performed. Both hands were then compared to each other. Furthermore, twelve control patients without contraindication for radial artery harvest in the non-dominant hand were examined. All 33 patients had contraindication for radial artery harvest in the non-dominant hand. Twenty-four (73%) had contraindication in the dominant hand as well. In terms of morphology, there was no statistically significant difference between the hands but circulatory parameters as a group suggested contraindication. Among controls, four patients (33%) had contraindication in the dominant hand. In the case of a non-harvestable radial artery in a hand there is clearly an increased risk for contraindication for radial artery harvest also in the other hand.
Forearm arterial pathology is correlated to carotid artery disease. When forearm vessel pathology is evident in preoperative examination, scanning of the carotid vessels should be considered.
Objectives: the radial artery is widely used as a graft in coronary artery bypass surgery (cabG). due to its location and function it should be screened prior to harvesting to avoid ischaemic complications of the hand. In acute situations the allen test is often the only preoperative screening method available. as has been noted earlier, a negative allen test does not mean a non-harvestable radial artery. we endeavoured to find out whether intraoperative pressure measurement could be used as a complement while screening the radial artery.Design: ninety patients planned for elective cabG with radial artery as a conduit were examined preoperatively with the allen test, handheld doppler and pletysmography of the second and fourth digits. radial artery pressure was measured intraoperatively. symptom scale was recorded pre-and postoperatively.Results: there were ten patients with a positive allen test. the intraoperative index of radial artery pressures was 0.868 in the allen positive group and 0.885 in the allen negative group with no statistically significant difference (p value .68). tolerance of exercise and cold was significantly impaired postoperatively, p values .002 and .001 respectively. no ischaemic complications occurred.Conclusions: Intraoperative pressure measurement can be used when screening radial arteries are to be harvested and no metric preoperative screening methods are available.
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