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Hand Perfusion in Patients with Physiological or Pathological Allen's Tests
Alexander K Bartella1, Nina Flick1, Mohammad Kamal1
1Department of Oral and Maxillofacial Surgery, Rheinisch-Westfälische technische Hochschule (RWTH) Aachen University, Aachen, northrhinewestfalia (NRW), Germany.
Journal of Reconstructive Microsurgery
|August 13, 2018
Summary
Patients with a pathological Allen test (AT) show significantly worse hand perfusion and slower recovery after radial artery occlusion compared to those with a physiological AT. This highlights the importance of AT results in assessing hand perfusion.
Area of Science:
- Vascular Surgery
- Hand Surgery
- Clinical Physiology
Background:
- The Allen test (AT) assesses dual vessel hand perfusion before surgery.
- The impact of a pathological AT on hand tissue perfusion remains unclear.
Purpose of the Study:
- To investigate hand perfusion changes in patients with physiological and pathological AT after cessation of dual blood supply.
Main Methods:
- 25 patients in each group (physiological and pathological AT).
- Laser Doppler-based "oxygen-to-see" (O2C) device used to measure perfusion of thumb, middle, and small fingers.
- Measurements taken at steady state and at 1, 3, 5, and 10 minutes after radial artery occlusion.
Main Results:
- Patients with pathological AT showed significant perfusion alterations in 8/18 measurements, versus 1/18 for physiological AT.
- Superficial and deep tissue oxygen saturation was significantly worse in the pathological AT group.
Conclusions:
- Pathological AT indicates greater vulnerability to loss of dual hand perfusion.
- Patients with pathological AT require longer recovery times to normalize perfusion patterns.