Collateral Circulation Testing of the Hand– Is it Relevant Now? A Narrative Review

Golamari, Reshma; Gilchrist, Ian C.

doi:10.1016/j.amjms.2020.12.001

Cited by 8 publications

(11 citation statements)

References 65 publications

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“…With its widespread use and clinical advantages to assess the collateral circulation, the predictive value of an Allen's Test is now increasingly being questioned, even with its fast and non-invasive attributes. 13 Despite the comparison with other available diagnostic tests (Barbeau test, palmar arch, and princeps pollicis artery ultrasound) reporting overall accuracy of 97.2%, 14 the Allen's Test suffers from a series of limitations: it is operator dependent, requires visual assessment and is frequently subjected to interobserver variation. 13,15 With a negative predictive value ranging from 18% to 99%, a positive result for abnormal collateral circulation is not considered a good predictor of hand ischemia and could lead to excluding the radial artery in favor of other insertion sites associated with greater procedural risks (e.g.…”

Section: Allen's Testmentioning

confidence: 99%

“…bleeding or infection after femoral artery cannulation). 13,15 On the contrary, if a negative Allen's Test is returned, further clinical assessment with Doppler Ultrasound or plethysmography and pulse oximetry (Barbeau) tests should be performed. 15…”

Section: Allen's Testmentioning

confidence: 99%

“…However there has been insufficient recent evidence looking at the incidence or clinical relevance of occlusion due to the large sample population required to demonstrate significance. 13 Ultrasound measurement of vessel diameter provides accuracy in determining the appropriate CVR, which may improve blood flow around intravascular devices, including arterial catheters. Although earlier research discusses venous implications, acknowledging relevant parallel characteristics for arterial devices should be considered.…”

Section: Local Anesthesiamentioning

confidence: 99%

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10 best practice tips with radial arterial catheterization

Imbrìaco

Spencer²,

Bardin-Spencer

2022

J Vasc Access

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Radial arterial catheters (RAC) are used extensively across critical care settings (Anesthesia, Intensive Care, Emergency Medicine) for continuous hemodynamic monitoring, allowing for immediate adjustments in vasopressor therapies and blood collection. Radial catheter failures are an ongoing significant issue for critical care clinicians with reported incidences at almost 25%. Common complications include loss of function, lack of blood return, poor quality waveforms and dislodgement, posing potential patient risks, and sudden loss of intra-arterial monitoring frequently requires prompt replacement. Contemporary research and technological improvements have highlighted several concepts to enhance the approach of RAC insertion and management while reducing immediate and late complications. The authors have prioritized the following 10 “best practice” aspects that may improve overall device function and reliability.

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Section: Allen's Testmentioning

confidence: 99%

Section: Allen's Testmentioning

confidence: 99%

Section: Local Anesthesiamentioning

confidence: 99%

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10 best practice tips with radial arterial catheterization

Imbrìaco

Spencer²,

Bardin-Spencer

2022

J Vasc Access

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“…However, these tests are not predictive of post procedure complications and are generally not recommended to include/exclude radial artery intervention suitability. 4,5 Further assessment of the radial arterial anatomy for potential vascular loops or anomalous connections is however recommended to assess suitability 4 although these variations are rare. 6 Radial artery access has demonstrated long term safety, in particular in the coronary intervention field, with no absolute contraindications.…”

Section: Radial Artery Assessmentmentioning

confidence: 99%

All that glitters: case presentation and review of radial access complications in neurointervention

et al. 2022

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Radial artery access has experienced increasing adoption and rapid expansion of indications for neurointerventional procedures. This access is an attractive neurointervention route to be considered, with many advantages over the traditional femoral access in terms of ease of vasculature navigation and decreased risk of complications such as significant bleeding. Although a promising technique for neurointerventional procedures, there are inherent and unique considerations as well as potential complications involved. The following case report highlights some of these vital concepts associated with radial artery access, including appropriate patient selection as well as assessment of arterial size in the context of neurointerventional techniques. Early identification of complications such as arterial injury and compartment syndrome, with an emphasis on appropriate draping and inter-procedure monitoring, is discussed as well as approaches for subsequent management. Finally, the issue of radiation safety in this emerging technique is considered. These concepts are critical for the successful use and the continued growth of radial artery access for neurointervention procedures.

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“…It is true that in literature there are also opposing opinions 1 and that the Society for Cardiovascular Angiography and Interventions (SCAI) does not recommend performing a collateral test before a cardiac procedure using a trans-radial approach, 2 but it is also true that the setting and priority are different: the Radialists use larger devices with short indwelling times, massive anticoagulation and, above all, have as their main objective the recanalization of the occluded coronary vessels, using a more secure technique than the femoral approach.…”

mentioning

confidence: 99%