ABSTRACT
Introduction. An uncommon complication of radial arterial blood sampling/cannulation is disruption ofthe artery (obstruction by clot), placing the hand at risk of ischemia. Those people who lack the dualsupply are at much greater risk of ischemia. The risk can be reduced by performing Allen’s test beforehand. People who have a single blood supply in one hand often have a dual supply in the other, allowingthe practitioner to take blood from the side with dual supply.The utility of the Allen’s test is questionable,[1] and no direct correlation with reduced ischemiccomplications of radial artery cannulation have ever been proven. In 1983, Slogoff and colleaguesreviewed 1,782 radial artery cannulations and found that 25% of them resulted in complete radial arteryocclusion, without apparent adverse effects.[2] A number of reports have been published in whichpermanent ischemic sequelae occurred even in the presence of a normal Allen’s test.[3, 4] In addition,the results of Allen’s tests do not appear to correlate with distal blood flow as demonstrated by fluorescein dye injections.[5, 6]Goal. Transradial coronary catheterization across the whole spectrum of Allen’s test results was safeand feasible to address the current uncertainty about the predictive capacity of the Allen’s test fortransradial access.Materials and Methods: This type of descriptive research methods. The patients assisted by SSCHand there were between the ages of 54-88, totally 28 patients. The hand is elevated and the patient/person is asked to make a fist for about 30 seconds.Pressure is applied over the ulnar and the radial arteries so as to occlude both of them.Still elevated, the hand is then opened. It should appear blanched (pallor can be observed at the fingernails). Ulnar pressure is released and the color should return in 7 seconds. If color returns as describedabove, the Allen’s test is considered to be “POSITIVE.” If color fails to return, the test is considered“NEGATIVE” and the ulnar artery supply to the hand is not sufficient. The radial artery therefore cannotbe safely pricked/cannulated.ResultPatients with non-normal Allen’s test results 32.1%.There weren’t any correlation of probability between positive Allen’s test and myocardial infarction, postPCI procedure (p value >0.05).There were correlation of probability between positive Allen’s test and dyslipidemia, DM (p value<0.05).Conclusion:1. We need perform Allen’s test indispensably when transradial coronary catheterization, becausethere were positive Allen’s test not small percent.2. There aren’t additional risk with old myocardial infarction and post PCI procedure patients, becausethere weren’t any correlation.3. There were correlation of probability between positive Allen’s test and dyslipidemia, DM. Thereforedoctors should select artery femoralis if patient have dyslipidemia and DM.
ABSTRACT
Objective To probe the safety of performing transradial artery percutaneous coronary intervention (PCI) for Allen test negative patients.Methods One hundred and six patients performed transradial artery PCI were enrolled in the study.The patients were divided into negative group (57 cases) and positive group (49 cases) according to Allen test results.Patients were performed ulnar artery angiography,deep palmar arch angiography and superficial palmar arch angiography.Ulnar artery diameter,deep palmar arch conditions,superficial palmar arch conditions,the frames counting through angiography on the side of ulnar vessel system,and hand ischemia after PCI (follow up for 3 months) was observed.Results There was no significant difference between negative group and positive group in parameters of ulnar artery diameter [(2.02 ±0.18) mm vs.(2.07 ±0.17) mm] and deep palmar arch and superficial palmar arch [85.96％ (49/57) vs.87.76％ (43/49),75.44％ (43/57) vs.81.63％ (40/49)] (P ＞0.05).The frames counting had no significant difference between negative group and positive group [(218.6 ± 63.6) frames vs.(180.8 ± 44.1) frames],but the ratio of the frames counting ≥380 frames had significant difference between negative group and positive group [14.04％(8/57) vs.2.04％(1/49)] (P ＜ 0.05).None of patients had been found to suffer from hand ischemia after PCI.Conclusion Transradial artery PCI is suitable for Allen test negative patients.
ABSTRACT
Objective To observe the safety and efficiency of SpO_2 -Allen's test in peri -puncture radial artery cannulation for invasive blood monitor. Methods 50 patients were selected for the radial artery cannulation in surgical intensive care unit(SICU). All of them were still sober. All of the patients were examined by SpO_2 -Allen's test and Allen's test before radial artery cannulation, 3 days after puncture and after pulling out the cannula. Resluts The results of Allen's test of 42 patients were negative,while those of 49 patients were negative in SpO_2 - Allen's test. Statistics difference existed between group of SpO_2 - Allen's text and group of Allen's text(P
ABSTRACT
Radial artery is frequently chosen for cannulation. Although the method is safe and simple, it can infrequently lead to tissue necrosis. This is a report of one case of amputation due to thumb necrosis developed from the radial artery cannulation in a patient who had open heart surgery. This is a 65 years old female who received a graft interposition of ascending aorta due to dissecting aortic aneurysm. Left radial artery cannulation was carried out after modified Allen's test appeared to be positive. On the 11 th postoperative days, we found that the catheter of left hand was obstructed, and we removed the catheter. On the 9 hrs after removal of catheter, thumb of left hand became color change and edematous with blister. On the 14 th days after removal of catheter, thumb of left hand became worsened to dusky purple to dark color change and pulseless, coldness. On the 20 th days after removal of catheter, amputation of thumb of left hand was performed.