HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jarvis, M. A. Articles by Spyt, T. J. Search for Related Content PubMed PubMed Citation Articles by Jarvis, M. A. Articles by Spyt, T. J.

Ann Thorac Surg 2000;70:1362-1365
© 2000 The Society of Thoracic Surgeons

---

Original articles: cardiovascular

Reliability of Allen’s test in selection of patients for radial artery harvest

^a Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, United Kingdom

Address reprint requests to Dr Martin A. Jarvis, Department of Cardiothoracic Surgery, Yorkshire Heart Centre, Great George St, Leeds LS1 3EX, UK
e-mail: martin-sie{at}cabg-jarvis.freeserve.co.uk

Background. Allen’s test is widely used to assess the ulnar collateral blood supply of the hand before radial artery harvest for coronary bypass surgery. This study was performed to determine the optimum cut-off point for a positive Allen’s test and the clinical reliability of Allen’s test in this role.

Methods. Patients undergoing coronary artery bypass surgery were examined by independent observers using both Allen’s test and a Doppler ultrasound test of the ulnar collateral circulation.

Results. We examined 93 hands in 47 patients; mean age was 63.6 years. Receiver operating characteristic analysis found that at a conventional cut-off of 6 seconds on Allen’s test had a sensitivity of 54.5%, specificity of 91.7%, and diagnostic accuracy of 78.5%. At a cut-off of 5 seconds diagnostic accuracy was maximal (79.6%), with sensitivity of 75.8% and specificity of 81.7%; 100% sensitivity occurred at a cut-off of 3 seconds, with specificity of 27% and diagnostic accuracy of 52%.

Conclusions. At no cut-off point does Allen’s test perform satisfactorily as a discriminatory test. It should be replaced by more objective tests, such as Doppler ultrasound.

This article has been cited by other articles:

				C. F. Chong Reply to the Editor: J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 785 - 786. [Full Text] [PDF]

				P. M. Vukovic, S. S. Radak, M. S. Peric, D. G. NeSic, and A. M. KneSevic Radial Artery Harvesting for Coronary Artery Bypass Grafting: A Stepwise-Made Decision Ann. Thorac. Surg., September 1, 2008; 86(3): 828 - 831. [Abstract] [Full Text] [PDF]

				S. J. Durham and J. P. Gold Late Complications of Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 535 - 548. [Full Text]

				M. Kohonen, O. Teerenhovi, T. Terho, J. Laurikka, and M. Tarkka Is the Allen test reliable enough? Eur. J. Cardiothorac. Surg., December 1, 2007; 32(6): 902 - 905. [Abstract] [Full Text] [PDF]

				A. Thompson and R. House Hand-arm vibration syndrome with concomitant arterial thrombosis in the hands Occup. Med., August 1, 2006; 56(5): 317 - 321. [Abstract] [Full Text] [PDF]

				M. J. Greenwood, A. J. Della-Siega, E. B. Fretz, D. Kinloch, P. Klinke, R. Mildenberger, M. B. Williams, and D. Hilton Vascular Communications of the Hand in Patients Being Considered for Transradial Coronary Angiography: Is the Allen's Test Accurate? J. Am. Coll. Cardiol., December 6, 2005; 46(11): 2013 - 2017. [Abstract] [Full Text] [PDF]

				A. Ronald, A. Patel, and J. Dunning Is the Allen's test adequate to safely confirm that a radial artery may be harvested for coronary arterial bypass grafting? Interactive CardioVascular and Thoracic Surgery, August 1, 2005; 4(4): 332 - 340. [Abstract] [Full Text] [PDF]

				A. N. Patel, A. C. Henry, C. Hunnicutt, C. A. Cockerham, B. Willey, and H. C. Urschel Jr Endoscopic radial artery harvesting is better than the open technique Ann. Thorac. Surg., July 1, 2004; 78(1): 149 - 153. [Abstract] [Full Text] [PDF]

				Y. Abu-Omar, S. Mussa, K. Anastasiadis, S. Steel, L. Hands, and D. P. Taggart Duplex ultrasonography predicts safety of radial artery harvest in the presence of an abnormal Allen test Ann. Thorac. Surg., January 1, 2004; 77(1): 116 - 119. [Abstract] [Full Text] [PDF]

				K. Kochi, K. Orihashi, and T. Sueda The snuffbox technique: A reliable color Doppler method to assess hand circulation J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 821 - 825. [Abstract] [Full Text] [PDF]

				L. R. Sajja, G. Mannam, and S. Sompalli Is Allen's test not reliable in the selection of patients for radial artery harvest? Ann. Thorac. Surg., July 1, 2002; 74(1): 296 - 296. [Full Text] [PDF]

				N. Roberts, S. Ghosh, M. Boehm, and M. Galinanes The radial hyperaemic response: a new and objective assessment of ulnar collateral supply to the hand Eur. J. Cardiothorac. Surg., March 1, 2002; 21(3): 549 - 552. [Abstract] [Full Text] [PDF]

				Z. S. Meharwal and N. Trehan Functional status of the hand after radial artery harvesting: results in 3,977 cases Ann. Thorac. Surg., November 1, 2001; 72(5): 1557 - 1561. [Abstract] [Full Text] [PDF]

				M. A. Greene and M. A. Malias Arm complications after radial artery procurement for coronary bypass operation Ann. Thorac. Surg., July 1, 2001; 72(1): 126 - 128. [Abstract] [Full Text] [PDF]