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Laser speckle contrast analysis for quantifying the Allen test: a feasibility study.

Stefan C Sandker1, Erwin Hondebrink, Jan G Grandjean

  • 1MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging group, University of Twente, P.O. Box 217, 7500, AE, Enschede, The Netherlands; Thoraxcenter Twente, Medisch Spectrum Twente, P.O. Box 50.000, 7500, KA, Enschede, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, Biomechanical Engineering group, University of Twente, P.O. Box 217, 7500, AE, Enschede, The Netherlands.

Lasers in Surgery and Medicine
|December 5, 2013
PubMed
Summary

Laser speckle contrast analysis (LASCA) offers an objective method to assess hand perfusion during the Allen test. This technique can reliably determine reperfusion time, aiding in pre-operative evaluations for coronary artery bypass graft surgery.

Keywords:
Allen testLASCAcoronary artery bypass graftradial arteryreperfusionulnar artery

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Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Diagnostic Tools

Background:

  • Radial artery is a common graft for coronary artery bypass graft (CABG) surgery.
  • The Allen test conventionally assesses ulnar artery patency before radial artery harvesting.
  • A positive Allen test (reperfusion >5 seconds) indicates potential insufficient hand perfusion by the ulnar artery.

Purpose of the Study:

  • To investigate if laser speckle contrast analysis (LASCA) can objectively determine hand reperfusion time.
  • To evaluate LASCA's efficacy in assessing ulnar artery collateral circulation.
  • To compare LASCA-based Allen test results with the conventional method.

Main Methods:

  • LASCA utilizes changes in laser speckle patterns caused by red blood cell movement to visualize hand perfusion.
  • Reperfusion time was measured on the palmar side of the hand, defined as time to maximum perfusion.
  • LASCA measurements were compared to the conventional Allen test in 30 patients undergoing CABG.

Main Results:

  • LASCA identified a negative Allen test in 16 patients.
  • Fourteen patients exhibited borderline or positive Allen test results.
  • No statistically significant difference was found between LASCA and the conventional Allen test (P=0.549 for left hand, P=0.223 for right hand).

Conclusions:

  • LASCA effectively visualizes hand perfusion and quantifies reperfusion responses (quick, moderate, slow, or absent).
  • Determining hand reperfusion time using LASCA is technically feasible.
  • LASCA serves as a valuable, objective tool for assessing ulnar collateral blood supply before radial artery harvesting for bypass grafts.