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Percutaneous arterial sampling was performed using transillumination. A success rate of 96% was obtained when sampling the radial, ulnar, posterior tibial, and dorsalis pedis arteries. Although small hematomas were produced despite pressure, no serious complications of infection, thrombotic obstruction, or thermal injury occurred. We conclude that the use of transillumination for arterial sampling is a safe technique that permits rapid sampling of very superficial peripheral arteries, allows visual confirmation of the Allen test for estimation of collateral flow, and would perhaps aid in arterial cannulation. Pediatrics, 59:1032-1035, 1977, TRANSILLUMINATION, ARTERIAL SAMPLING.

Resume L'examen velocimetrique par ultrasonographie en mode Doppler a emission continue a ete pratique pour la surveillance de 35 arteres ulnaires ou radiales reparees en urgence, a la suite d'un traumatisme, et de 13 arteres reparees secondairement. Compare au test d'Allen, l'examen Doppler est apparu plus sensible en ce qu'il s'est montre capable de distinguer, parmi les arteres non fonctionnelles vis-a-vis de la vascularisation de la main et des doigts, les arteres absentes des arteres presentes mais non fonctionnelles. Parmi ces dernieres, le Doppler a permis encore de distinguer les arteres non disponibles des arteres disponibles, repondant positivement a la compression de l'autre axe. Cette etude permet d'apporter des arguments supplementaires pour la definition des indications chirurgicales de reparation arterielle.

The present study is a review of the cases of 25 patients who allowed to enter this hospital for further evaluation and diagnosed Scalenus Syndrome from '68 Nov. to '70 Oct.We classified under the following three type; vascular type, neurological type and combined type.1. In angiography, the stenosis or obstruction was observed in vascular type, but, no stenosis was observed in neurological type.2. In motor and sensory nerve action potential the delay of velocity motor nerves and sensory nerves could not be observed, but the amplitude of sensory nerves decreased in 2 cases with neurological and combined type.3. The autonomic nerve system test was showed abnormality in 8 cases of 10.4. Allen test was of no value as diagnostic test. Adson test was seen in 50% patients positive and Halstead test was 70% positive.

The dose-response relationship between vibration exposure and vascular disorders in the hands was examined in platers. The study was based on a cross section of 89 platers and 61 office workers divided according to exposure to vibration into four groups. Vibration exposure was assessed by measuring the acceleration intensity on a sample of tools, together with both subjective rating and objective measurements of the exposure time. The frequency-weighted energy equivalent acceleration for 4 h was 4.6–4.7 m/s2. The point prevalence of white fingers was 42% for the plater category currently exposed with an odds ratio of 85. The time laps before contraction of white fingers (latency time) was four years for the 10th percentile, and was shorter than predicted according to the ISO-5349 standard. The prevalence of white finger symptoms staged according to the Taylor-Pelmear scale was comparable to the prevalences according to the Stockholm Workshop Scale. Vibration exposure was the dominant source of white fingers and each year of vibration exposure increased the odds ratio for white fingers by 11%. Distal circulation in the hands was assessed by a timed Allen test. The odds ratio for a positive Allen test was higher for the workers exposed to vibration compared to the non-exposed workers. The use of the timed Allen test is suggested in the clinical examination for vibration white fingers. The observed high risk for contracting white fingers could be prevented by exposure level reduction and/or restriction of exposure duration.

Excerpt To the editor: In their response to Raffin's (1) review of indications for arterial blood gas analysis, Williams and Schenken (2) take exception to Dr. Raffin's statement "An Allen test sho...

In 14 cases aged 9-79 years the radial forearm flap has been used for reconstruction. Of 4 island flaps, 2 were distally based (1 with nerve anastomosis) and 2 proximally based (1 innervated). Of the free flaps, 7 were for intra-oral lining following major resection and 3 of these included hemi-radius for mandibular reconstruction. Most flaps were put into a hostile environment resulting from chronic infection and/or radiotherapy or fast neutron therapy. Two flaps failed including one osseocutaneous free flap. Important anatomical, pre-operative and operative aspects are considered, including a description of the timed Allen test, and potential pitfalls and refinements are described.

Summary A review of the literature concerning ischaemic complications following radial artery cannulation suggests that the Allen test has little predictive validity. Other methods of assessing the ulnar collateral circulation are discussed.

The ulnar arterial circulation to bilateral hands of 683 men and 787 women was assessed with the Allen radial artery compression test. Of the 2,940 arms, the Allen test showed abnormalities in 105 (3.6%). The incidence of abnormality generally increased with age: 2.2% in the first decade and 6.9% after the ninth decade. It is very likely that circulatory failure in the hand develops after several decades among those whose radial artery was removed in their youth. When the radial artery is removed in the young, attention should therefore be paid to future consequences.

Der Sinn unserer Untersuchung lag in der Entwicklung eines objektiven, schnellen und aufzeichenbaren Tests zur Beurteilung der funktionellen Hohlhandcollateralen (Hohlhandbogen). Der bisher gebrauchliche Allen-Test unterliegt subjektiven Kriterien, kann nicht aufgezeichnet werden und liefert einen hohen Anteil falscher Ergebnisse. Basierend auf der Doppler-Technik besteht unser Test aus zwei objektiven Kriterien: 1. der nachgewiesenen Stromungsumkehr in der distalen Radialis bei deren proximaler Kompression, 2. im Nachweis der pulsatilen Stromung in den Daumenarterien bei Verschlusskompression der distalen Arteria radialis.

Excerpt To the editor: In the excellent and timely review of indications for arterial blood gas analysis (1), Dr. Raffin states that "an Allen test should be done to assess adequacy of collateral c...

Previous studies have shown that the right radial approach encounters more tortuosity than the left radial approach during transradial coronary angiography. The objective of this study was to compare the procedural difficulty of the right and left radial approaches in the modern era with dedicated transradial catheters. One hundred ninety-three patients scheduled for transradial coronary angiography with normal Allen test results and without histories of coronary artery bypass grafting were randomized to the right or left radial approach. The choice of catheter was left to the discretion of the operator, with the preferred catheter being a dedicated transradial Optitorque catheter. The primary end point was procedural difficulty, defined as (1) hydrophilic or coronary wire use for tortuosity, (2) stiff wire use for the coronary engagement, (3) multiple catheters used, or (4) nonselective injection. The clinical characteristics were similar between the 2 groups. Procedural success was achieved in 98 of 101 (98%) in the right radial group and 91 of 92 (99%) in the left radial group. Procedural difficulty, fluoroscopy time, and contrast use were similar between the 2 groups. The use of a single catheter was more common in the right radial group (73% vs 18%, p