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Transradial Approach for Cardiac Catheterization in Patients With Negative Allen's Test
Christos Maniotis1, Michalis Koutouzis, Constantinos Andreou
12nd Cardiology Department of Hellenic Red Cross Hospital, Athens, Greece. chrmn21@gmail.com.
Insights
The transradial approach for coronary angiography is safe and effective, even when the Allen's test is negative. This cardiac catheterization technique shows similar outcomes regardless of pre-procedural Allen's test results.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- The transradial approach is a common method for cardiac catheterization.
- The Allen's test is traditionally used to assess collateral circulation before radial artery cannulation.
Purpose of the Study:
- To evaluate the safety and efficacy of the transradial approach for coronary angiography and angioplasty, irrespective of Allen's test outcomes.
- To determine if a negative Allen's test impacts the success or complication rates of transradial procedures.
Main Methods:
- A prospective study of 1035 patients undergoing transradial coronary angiography/angioplasty.
- Allen's test was performed pre-procedure; catheterization proceeded regardless of results.
- Radial artery patency was assessed post-procedure.
Main Results:
- 24.7% of patients had a negative Allen's test, 75.3% had a positive test.
- No significant differences in baseline characteristics, procedural success, or complications were observed between groups.
- Radial artery thrombosis occurred in 6.2% of the negative Allen's test group and 4.8% of the positive group, with no clinical impact.
Conclusions:
- The transradial approach is a safe and effective method for coronary angiography and angioplasty.
- Pre-procedural Allen's test results do not appear to influence the safety or efficacy of the transradial approach.
Aims:
To assess the efficacy and safety of transradial approach regardless of the Allen's test results for coronary angiography and angioplasty.
Methods And Results:
Prospective data collection of 1035 consecutive patients who underwent coronary angiography with or without ad hoc angioplasty through the radial approach was conducted. Baseline demographic and procedural data were recorded. Allen's test was evaluated in all subjects before the procedure and catheterization was performed from the radial approach irrespective of the results. Radial artery patency was evaluated at discharge clinically, or by Doppler examination if pulse was not palpable. A total of 256 patients (24.7%) were found to have a negative Allen's test and 779 patients (75.3%) had a positive test. The baseline and procedural characteristics were similar in both groups. No significant differences in complications were reported. Radial artery thrombosis was observed in 6.2% of the negative Allen's test group and 4.8% of the positive Allen's test group (P=.85), but this was clinically silent even in the negative Allen's test group.
Conclusion:
Transradial approach for coronary angiography and ad hoc angioplasty can be performed with similar efficacy and safety regardless of the Allen's test results before the procedure.
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Pre-Procedural Preparation