Variability of forearm collateral circulation: An observational study of serial hand plethysmography testing

SCAI expert consensus statement update on best practices for transradial angiography and intervention

“…Importantly, the functional patency of the ulnopalmar arches of the hand varies over time in patients who undergo radial access, with those with abnormal test results displaying improvements after transradial access . Furthermore, plethysmographic testing of forearm circulation demonstrates variability even over short intervals, further discrediting such collateral testing for acute access triage. The underlying digital vascular supply is robust and well preserved during occlusive radial access, irrespective of the anatomic variations and results of noninvasive patency tests…”

Slender versus conventional approach reduces post‐procedural upper extremity dysfunction after transradial coronary procedures

“…Our explanation is that, by the use of multiple and elaborated tests, and the lack of a MICD threshold, the incidence of postprocedural UED might have been previously overestimated beyond clinical relevance. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] By using QuickDASH, and setting MICD at 8, we knowingly chose for an easy and yet reliable tool. In our experience, and after correction for confounders, slender TRA procedures showed a lower incidence of early (2 weeks) post-procedural UED.…”

“…After removal of the compression and before discharge, the Reverse Barbeau Test (RBT) is performed. As first, a pulse oximeter is placed on the thumb, 19 and then manual compression on the ipsilateral ulnar artery is applied for at least 10 s. An abnormal (positive) RBT is reported when the pressure curve becomes and remains permanently flat until release of the ulnar compression. A normal (negative) RBT occurs when the pressure curve remains pulsatile or recovers shortly after initial flattening.…”