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We investigated whether Allen test is necessary before transradial approach.
Transradial approach has been feasible and effective for cardiac and other vascular interventions in recent years. Most operators use a modified Allen test due to known collateral circulation in the hand; however, the definition of abnormal Allen test is not consistent and necessity before radial cannulation is not well defined.
The study population consisted of 2650 patients who had been performed cardiac catheterization or peripheral angiography (abdominal aortic, lower extremity) via radial access between 2011 and 2013. All of the patients were retrospectively investigated. Sixty five patients (Group A) had abnormal Allen test before transradial catheterization. One hundred and thirty age, sex and risk factors matched patients who had normal Allen test before transradial catheterization was taken as control group (Group B). No other test was used to assess collateral circulation in the hand. Standard cannulation techniques were used. One month after the procedure, all of the patients were performed Doppler ultrasonography for radial artery flow.
Procedural success was similar between both groups (96.9% and 98.5%, p=0.367), and no major complication (subacute or delayed occlusion, spasm, hematoma, compartment syndrome, perforation/laceration/dissection, avulsion, AV fistula, pseudoaneurysm, digital ischemia, transient vocal cord paralysis) was developed in both groups during and after the procedure. Minor complications (subcutaneous edema, paresthesia, and ecchymosis) were developed in three patients in group A. However, none of them required surgical intervention. Doppler ultrasonography showed normal radial flow patterns in both study groups at one month post-procedural follow-up.
Allen test may not be necessary before transradial access.