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Ann Thorac Surg 1998;65:1167
© 1998 The Society of Thoracic Surgeons

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How to Do It

Simplified Method for Candidate Selection for Radial Artery Harvesting

^a Division of Thoracic and Cardiovascular Surgery, Memorial Hospital, Ormond Beach, Florida, USA

Accepted for publication November 6, 1997.

Address reprint requests to Dr Johnson, 588 Sterthaus Ave, Ormond Beach, FL 32174

	Abstract

Top Abstract Introduction Technique Comment References

 
With the renewed interest in the use of autogenous radial arteries in coronary artery bypass grafting, concerns regarding vascular compromise and selection of patients have arisen. In this report, we describe a modification of Allen’s test.

	Introduction

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Recent studies have sparked a renewed interest in the use of autogenous radial arteries in coronary artery bypass grafting [1–4]. Valid concerns regarding vascular compromise to the hand have given rise to different methods of assessing for radial artery dominance [5]. In this report, a simple modification of Allen’s test is described.

	Technique

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The test consists of attaching an oxygen saturation monitor on the thumb or forefinger of the appropriate hand of the patient. A baseline oxygen saturation measurement is then taken. The radial and ulnar arteries are palpated and then compressed until the oxygen saturation reading falls to zero. Pressure on the ulnar artery is released. The time it takes for the oxygen saturation to return to baseline is noted. Twelve seconds is used as the maximum time limit to safely harvest the radial artery. This was an arbitrarily selected time limit.

	Comment

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Over the past 23 months, 452 radial arteries in 401 patients have been safely harvested after performance of this test. There have been no instances of vascular compromise in these patients. In the same time period, 5% of tested patients (21 patients) were diagnosed with radial artery dominance, either unilateral or bilateral. The radial artery was not harvested in this group. This modification of Allen’s test has been shown to be simple to do, to add little or no cost to the procedure, and to be reliable.

	References

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1. Acar C., Jebara V.A., Portoghese M., et al. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 1992;54:652-660.[Abstract/Free Full Text]
2. Reyes A.T., Frame R., Brodman R.F. Technique for harvesting the radial artery as a coronary artery bypass graft. Ann Thorac Surg 1995;59:118-126.[Abstract/Free Full Text]
3. Dietl C.A., Benoit C.H. Radial artery graft for coronary revascularization: technical considerations. Ann Thorac Surg 1995;60:102-110.[Abstract/Free Full Text]
4. Da Costa F.D.A., da Costa I.A., Poffo R., et al. Myocardial revascularization with the radial artery: a clinical and angiographic study. Ann Thorac Surg 1996;62:475-480.[Abstract/Free Full Text]
5. Pola P., Serricchio M., Flore R., Manasse E., Favuzzi A., Possati G.F. Safe removal of the radial artery for myocardial revascularization: a Doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg 1996;112:737-744.[Abstract/Free Full Text]

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This Article Abstract 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 Author home page(s): William H. Johnson, III Jack E. Arrants John B. Holt Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Johnson, W. H. Articles by Holt, J. B. Search for Related Content PubMed PubMed Citation Articles by Johnson, W. H., III Articles by Holt, J. B.