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

Journal of Otolaryngology-Head & Neck Surgery

David P. Goldstein¹  Ralph Gilbert¹  John R. de Almeida¹  Andrew Foreman¹ 

[1] Department of Otolaryngology Head and Neck Surgery, University Health Network, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada

关键词: Endovascular;    Head and neck cancer;    Reconstruction;    Radial artery;    Allen’s test;   

Others  :  1230363
DOI  :  10.1186/s40463-015-0096-0

 received in 2015-08-04, accepted in 2015-10-15,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Foreman et al.

【 图 表 】

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