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Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
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Correlation of modified allen test with Doppler ultrasonography
Kerim Cagli1, Alper Uzun, Mustafa Emir
1Cardiovascular Surgery Clinic, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. vedatbakuy@yahoo.com
Asian Cardiovascular & Thoracic Annals
|March 23, 2006
Summary
Modified Allen tests using plethysmography, pulse oximetry, and pencil Doppler reliably assess forearm arterial circulation. These methods correlate well with Doppler ultrasonography for evaluating radial artery grafting suitability.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Preoperative Assessment
Background:
- Radial artery grafting is crucial for coronary artery bypass grafting (CABG).
- Accurate preoperative assessment of forearm arterial circulation is essential for graft patency and patient safety.
- The modified Allen test is a common bedside method, but its reliability and correlation with advanced imaging require further validation.
Purpose of the Study:
- To evaluate the feasibility of modified Allen tests in assessing forearm arterial circulation for radial artery grafting.
- To determine the correlation between modified Allen tests (using plethysmography, pulse oximetry, pencil Doppler) and Doppler ultrasonography.
- To establish criteria for safe and effective preoperative arterial evaluation.
Main Methods:
- Fifty patients undergoing CABG were assessed using modified Allen tests with plethysmography, pulse oximetry, and pencil Doppler.
- Doppler ultrasonography was employed to measure flow, velocity, and diameter of radial, ulnar, and snuffbox arteries.
- Radiological screening indices were evaluated to establish standard assessment criteria.
Main Results:
- Modified Allen tests using plethysmography and pulse oximetry indicated ulnar artery dominance in most patients.
- Doppler ultrasound measurements (flow x diameter, velocity x diameter) corroborated the ulnar artery dominance.
- Sequential arterial compression revealed significant circulatory alterations, highlighting the importance of comprehensive assessment.
Conclusions:
- Modified Allen tests, when performed with plethysmography, pulse oximetry, and pencil Doppler, are feasible and safe for evaluating forearm arterial circulation.
- These bedside methods demonstrate a strong correlation with Doppler ultrasound findings.
- The study validates the use of modified Allen tests as a reliable tool for preoperative assessment prior to radial artery harvesting for CABG.
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