Kwon Woo-Keun, Yoon Wonki, Kwon Taek-Hyun, Kim Jong Hyun, Jung Heung-Sub, Ahn Jaegeun, Huh Hanyong, Ji Choel
Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Focused Training Center for Trauma, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Clin Neurol Neurosurg. 2018 Jan;164:14-18. doi: 10.1016/j.clineuro.2017.10.035. Epub 2017 Oct 31.
Transradial cerebral angiography (TRCA) has been introduced as an alternative technique for the transfemoral access, and its use is becoming more common in the field. In this study, we retrospectively analyzed a group of patients who received TRCA, and investigated peri-procedural measurements indicating actual hand circulation, and studied their correlation with the Allen test.
A retrospective review of 168 patients whom underwent TRCA between 2015 July and 2016 July, were included in this study. Pre procedural Allen test and Doppler ultrasonography for the radial artery (RA) and ulnar artery (UA) were done. Plethysmography tests as well as pulse oximetry monitoring were done before and during the procedure and intra-procedural angiography of the forearm and hand was done for assessment of palmar circulation.
Pre-procedural UA diameters revealed statistically significant correlation with manual Allen test results (P <0.001, r=-0.381). The DUS RA diameters, however, did not correlate with any other pre-procedural measurements. The mean contrast filling time on forearm angiography was 3.33±1.97s, and it showed statistically significant correlation with the capillary filling time of Allen tests (P<0.001, r=0.389).
Manual Allen test results correlated with angiographic capillary filling of the distal hand circulation and pre-procedural UA diameters. Our results suggest that Allen test sufficiently represent the collateral circulation status prior to TRCA.
经桡动脉脑血管造影术（TRCA）已作为经股动脉入路的替代技术被引入，且其在该领域的应用正变得越来越普遍。在本研究中，我们回顾性分析了一组接受TRCA的患者，研究了表明实际手部循环的围手术期测量指标，并探讨了它们与艾伦试验的相关性。
本研究纳入了2015年7月至2016年7月期间接受TRCA的168例患者。术前进行了艾伦试验以及桡动脉（RA）和尺动脉（UA）的多普勒超声检查。在手术前和手术期间进行了体积描记法测试以及脉搏血氧饱和度监测，并在术中对前臂和手部进行血管造影以评估手掌循环。
术前UA直径与手动艾伦试验结果具有统计学显著相关性（P<0.001，r=-0.381）。然而，DUS RA直径与任何其他术前测量指标均无相关性。前臂血管造影的平均造影剂充盈时间为3.33±1.97秒，且与艾伦试验的毛细血管充盈时间具有统计学显著相关性（P<0.001，r=0.389）。
手动艾伦试验结果与手部远端循环的血管造影毛细血管充盈及术前UA直径相关。我们的结果表明，艾伦试验足以代表TRCA术前的侧支循环状态。
