title: The lower-extremity Allen test.
abstract: The Allen test is used to diagnose the relative contribution of the ulnar and radial arteries to each hand. We modified this test to investigate the relative vascular contributions to distal perfusion of the lower extremity. With the patient supine, a handheld Doppler is used to locate the first dorsal metatarsal artery. The posterior tibial artery (PT) and dorsalis pedis artery (DP) pulses are compressed. A persistent signal indicates collateral flow through the peroneal artery (PA). Sequential decompression is then used to evaluate the relative contribution of the PT and DP to distal circulation. We report a case in which angiography failed to predict reliance on the PT. In this case, performance of the lower-extremity Allen test (LEAT) led to an alternative recipient vessel choice. The LEAT is simple to perform and provides a valuable adjunct to angiographic data.
authors.affiliation: New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York 10016, USA.
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Haddock
authors.forename: Evan S
authors.initials: ES
authors.lastname: Garfein
authors.forename: Pierre B
authors.initials: PB
authors.lastname: Saadeh
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Levine
mesh_terms: D000368:Aged; D000465:Algorithms; D000714:Anastomosis, Surgical; D000792:Angiography; D005260:Female; D005528:Foot / Q000098:blood supply*; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D008866:Microsurgery; D019651:Plastic Surgery Procedures; D017568:Rectus Abdominis / Q000637:transplantation; D012039:Regional Blood Flow; D016038:Skin Transplantation; D016909:Tibial Arteries / Q000502:physiology*; D018608:Ultrasonography, Doppler