艾伦试验：在经桡动脉血管腔内介入手术时代，重新审视双向测试对于确定前臂桡侧游离皮瓣切取的适应证及设计的重要性。
The Allen's test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures.
作者信息
Foreman Andrew, de Almeida John R, Gilbert Ralph, Goldstein David P
机构信息
Department of Otolaryngology Head and Neck Surgery, University Health Network, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
出版信息
J Otolaryngol Head Neck Surg. 2015 Nov 4;44:47. doi: 10.1186/s40463-015-0096-0.
BACKGROUND
The radial forearm free flap is a workhorse free flap. The radial artery, which supplies it, is increasingly being used for endovascular access. A complication of this is radial artery occlusion. Although often asymptomatic it can compromise future free tissue transfer.
CASE PRESENTATION
Two patients who underwent RFFF harvest for head and neck reconstruction are presented; both of who likely had distal radial artery occlusion. The first patient had failure of flap perfusion, presumed secondary to radial artery occlusion from prior endovascular access at the distal radial artery. In the second case, we used the Allen's test in reverse to identify the same scenario and successfully redesigned the harvest.
CONCLUSION
The Allen's test is a simple bedside test that should be performed bidirectionally to exclude radial artery occlusion, which may compromise flap harvest. Radial artery occlusion will become increasingly common as the radial artery is used more frequently for endovascular access procedures.
背景
桡侧前臂游离皮瓣是一种常用的游离皮瓣。为其供血的桡动脉越来越多地被用于血管内通路。这样做的一个并发症是桡动脉闭塞。尽管通常无症状，但它可能会影响未来的游离组织移植。
病例介绍
介绍了两名接受桡侧前臂游离皮瓣切取用于头颈部重建的患者；两人可能都存在桡动脉远端闭塞。首例患者皮瓣灌注失败，推测继发于先前在桡动脉远端进行血管内通路操作导致的桡动脉闭塞。在第二例中，我们反向使用艾伦试验来识别相同情况，并成功重新设计了皮瓣切取。
结论
艾伦试验是一种简单的床旁检查，应双向进行以排除可能影响皮瓣切取的桡动脉闭塞。随着桡动脉越来越频繁地用于血管内通路操作，桡动脉闭塞将变得越来越常见。
Zotero 插件