title: Evaluation of hand circulation with CardioWaves photoplethysmograph device during Allen test in healthy volunteers.
abstract: OBJECTIVE
  Radial artery occlusion is a potential complication of transradial procedures and its occurrence ranges from 0.8 to 30%. It is virtually always asymptomatic but the functional and sensorial consequences of a long acting hand hypoperfusion could go underestimated. CardioWaves is a novel photoplethysmograh device that allows us to detect the pulse wave amplitude of the blood flowing to the hand. Our objective was to assess in normal subjects the hand blood flow supplied by radial arteries and ulnopalmar arches, respectively, by using CardioWaves device during modified Allen's test (MAT).
  
  
  METHODS
  MAT was performed on both hands of 60 normal subjects, age ranging 21 to 66 years, without any cardiovascular factor risk.
  
  
  RESULTS
  Photoplethysmograh and MAT showed a high positive linear correlation (r=0.93). Despite that, MAT tends to give a higher reading by between 1.05 and 1.6 sec. 11 of 120 readings (9%) by CardioWaves showed values of radial/ulnar pulse amplitude ratio more than mean + 1 SD, suggesting a significant decrease in ulnopalmar arterial circulation when radial blood flow supply would ceased.
  
  
  CONCLUSIONS
  The CardioWaves device allows us an accurate reading of the flow because of its independency from respiratory changes. Furthemore, the evaluation of radial and ulnar pulse wave amplitude and the ratio between them would reveal an insufficient blood flow supply by the ulnar artery irrespective of the MAT results. We suggest that their assessment before performing coronary angiography and interventions may reduce potential complication of transradial access.
authors.affiliation: Department of Heart and Great Vessel "A. Reale", Sapienza University of Rome, Rome, Italy. gaetano.tanzilli@uniroma1.it.
authors.forename: G
authors.initials: G
authors.lastname: Tanzilli
authors.forename: G
authors.initials: G
authors.lastname: Truscelli
authors.forename: F
authors.initials: F
authors.lastname: Barillà
authors.forename: N
authors.initials: N
authors.lastname: Cocco
authors.forename: G
authors.initials: G
authors.lastname: Pannitteri
authors.forename: A
authors.initials: A
authors.lastname: Tanzilli
authors.forename: S
authors.initials: S
authors.lastname: Al Kindy
authors.forename: E
authors.initials: E
authors.lastname: Mangieri
authors.forename: C
authors.initials: C
authors.lastname: Gaudio
mesh_terms: D000328:Adult; D000368:Aged; D003097:Collateral Circulation; D005260:Female; D006225:Hand / Q000098:blood supply* / Q000294:innervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017156:Photoplethysmography / Q000379:methods*; D017534:Radial Artery / Q000294:innervation / Q000502:physiology*; D012039:Regional Blood Flow; D055815:Young Adult