Evaluation of collateral circulation of the hand

@article{Fuhrman2005EvaluationOC,
  title={Evaluation of collateral circulation of the hand},
  author={Thomas M. Fuhrman and William Pippin and Lance A. Talmage and Thomas E. Reilley},
  journal={Journal of Clinical Monitoring},
  year={2005},
  volume={8},
  pages={28-32}
}
In 1929, Edgar V. Allen described a noninvasive evaluation of the patency of the arterial supply to the hand of patients with thromboangitis obliterans (Am J Med Sci 1929;178:237). In the early 1950s, Allen's test was modified (Wright I. Vascular diseases in clinical practice. Chicago: Year Book Medical Publishers, 1952) for use as a test of collateral circulation prior to arterial cannulation. This test involves the examiner occluding the patient's ulnar and radial arteries while the patient… 
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References

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Clinical Evaluation of Blood Flow to the Hand: The False‐Positive Allen Test
TLDR
The authors recommend that the Allen test be performed with the patient's hand slightly flexed and relaxed, and no individual artery required more than 6 seconds for the flush to appear after opening of the hand.
Evaluation of the palmar circulation by pulse oximetry
TLDR
Using the photoplethysmographic component of the pulse oximeter may improve the assessment of collateral circulation of the hand in which arterial cannulation is being contemplated.
Thrombosis following percutaneous radial artery cannulation
TLDR
The incidence of thrombosis was not correlated to sex, age, size of artery (judged by wrist circumference), cannulation technique or the presence of hypotension, but it did, however, correlate to the existence of haematoma at the puncture site.
Severe ischemia of the hand following radial artery catheterization.
TLDR
Percutaneous radial artery catheterization for blood gas monitoring and continuous arterial pressure recording has become a common place procedure in the management of critically ill patients and review of the events preceding and during cannulation allowed elucidation of the following principles.
Allen's test performed by pulse oximeter
TLDR
It is suggested that it is more helpful to look at the question from the standpoint of pathology rather than anatomy, to consider what goes into the space, a t what level and for how long, and the condition of the intervening tissues.
Physiologic anatomy of the palmar circulation in 200 normal hands.
TLDR
The functional capacity of the Superficial Palmar Arch (SPA) was evaluated in 200 normal hands by a non-invasive narrow beam ultrasonic technique and the use of tobacco does not increase the incidence of incomplete SPAs.
Complications of Percutaneous Radial-artery Cannulation: An Objective Prospective Study in Man
TLDR
One hundred and five percutaneous radial-artery cunnulations were prospectively studied in 100 patients, with a high incidence of temporary thrombosis, and radial arterial pulses produced by retrograde ulnar-arterY flow were palpable distal to 73 per cent of the radialartery thrombi.
Radial artery cannulation and ishaemic damage: a review
A review of the literature concerning ischaemic complications following radial artery cannulation suggests that the Allen test has little predictive validity. Other methods of assessing the ulnar
Photo-electric plethysmography as a monitoring device in anaesthesia. Application and interpretation.
TLDR
Physiologically, changes in blood volume pulsations depend on the distensibility of the vessel wall as well as on the intravascular pulse pressure, and it is shown that changes in the height of ventilatory waves may be of diagnostic significance.
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