Sharon C Kiang1, Arian J Nasiri2, Ryan R Strilaeff2, Vinoy S Prasad3, Aditya S Bharadwaj3, Paul A Miller4, Ahmed M Abou-Zamzam5, Roger T Tomihama6. 1. Division of Vascular Surgery, Department of Surgery, Linda University School of Medicine, Loma Linda, CA; Division of Vascular Surgery, Department of Surgery, VA Loma Linda Healthcare System, Loma Linda, CA. 2. Department of Radiology, Section of Vascular and Interventional Radiology, Linda University School of Medicine, Loma Linda, CA. 3. Division of Cardiology, Department of Medicine, Linda University School of Medicine, Loma Linda, CA. 4. Division of Vascular Surgery, Department of Surgery, VA Loma Linda Healthcare System, Loma Linda, CA. 5. Division of Vascular Surgery, Department of Surgery, Linda University School of Medicine, Loma Linda, CA. 6. Department of Radiology, Section of Vascular and Interventional Radiology, Linda University School of Medicine, Loma Linda, CA. Electronic address: rtomihama@llu.edu.
Abstract
BACKGROUND: There is no currently accepted standard in safety evaluation for radial artery intervention. We sought to compare the accuracy of various subjective and objective screening techniques in predicting safety for radial artery intervention. METHODS: Fifty-four patients in a prospective cohort study at a single institution underwent subjective Allen's test, objective Barbeau test, and several objective hand ultrasound techniques to assess safety for radial artery intervention. These results were then compared to the gold standard of conventional hand angiography to document complete palmar arch. Statistical analysis including sensitivity, specificity, positive predictive values, negative predictive values, and accuracy were calculated. RESULTS: Compared to hand angiography, the subjective Allen's test and the objective Princeps Pollicis Artery ultrasound demonstrated the comparable levels of sensitivity (100% vs. 96.7%, respectively), specificity (100% vs. 100%, respectively), and accuracy (97.2% vs. 97.1%, respectively). The objective Barbeau test demonstrated similar results (sensitivity of 100%, accuracy of 98.2%) with the exception of a lower specificity (50%). CONCLUSIONS: There is no currently accepted standard in safety evaluation for radial artery intervention. However, preliminary data suggest that certain subjective and objective techniques such as Allen's testing, Princeps Pollicis artery ultrasound, and Barbeau testing are comparable options in predicting palmar arch patency.
BACKGROUND: There is no currently accepted standard in safety evaluation for radial artery intervention. We sought to compare the accuracy of various subjective and objective screening techniques in predicting safety for radial artery intervention. METHODS: Fifty-four patients in a prospective cohort study at a single institution underwent subjective Allen's test, objective Barbeau test, and several objective hand ultrasound techniques to assess safety for radial artery intervention. These results were then compared to the gold standard of conventional hand angiography to document complete palmar arch. Statistical analysis including sensitivity, specificity, positive predictive values, negative predictive values, and accuracy were calculated. RESULTS: Compared to hand angiography, the subjective Allen's test and the objective Princeps Pollicis Artery ultrasound demonstrated the comparable levels of sensitivity (100% vs. 96.7%, respectively), specificity (100% vs. 100%, respectively), and accuracy (97.2% vs. 97.1%, respectively). The objective Barbeau test demonstrated similar results (sensitivity of 100%, accuracy of 98.2%) with the exception of a lower specificity (50%). CONCLUSIONS: There is no currently accepted standard in safety evaluation for radial artery intervention. However, preliminary data suggest that certain subjective and objective techniques such as Allen's testing, Princeps Pollicis artery ultrasound, and Barbeau testing are comparable options in predicting palmar arch patency.
Authors: Karen A García-Rueda; César H Cediel-Barrera; Maribel Plaza-Tenorio; John U Cataño-Bedoya; Juan C Ortiz-Uribe; Keyner Toro-Osorio; Mailyn Peña-Pineda; Juan M Senior-Sánchez Journal: Arch Cardiol Mex Date: 2022-04-04