Allen test for assessment of blood circulation in the hand before insertion of an arterial catheter

Patients with impaired blood circulation in the hand is assumed to have greater risk of complications due to insertion of an arterial catheter. Allen test is one of several methods that can be used to identify these people.

Reading time approx. 8 minutes Published: June 29, 2021 Publication type:

SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: June 29, 2021 Report no: ut202116 Registration no: SBU 2020/679

Question

What scientific studies are there on Allen test or other similar tests and their capability to predict complications after insertion of an arterial catheter?

Identified literature

One relevant systematic review was identified but was assessed to have high risk for bias. Two relevant primary studies were identified [1,2]. The primary studies were not assessed for risk of bias.

References

Jirous S, Bernat I, Slezak D, Miklik R, Rokyta R. Post-procedural radial artery occlusion and patency detection using duplex ultrasound vs. the reverse Barbeau test. Eur Heart J Suppl 2020;22:F23-f29.
Maniotis C, Koutouzis M, Andreou C, Lazaris E, Tsiafoutis I, Zografos T, et al. Transradial Approach for Cardiac Catheterization in Patients With Negative Allen's Test. J Invasive Cardiol 2015;27:416-20.

Literature search

PubMed via NLM 210125

Allen test for assessment of blood circulation in the hand before insertion of an arterial catheter

	Search terms	Items found
The search result, usually found at the end of the documentation, forms the list of abstracts. [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Population:
1.	(cannulation OR cannulations OR catheter[tiab] OR "Catheterization, Peripheral"[Mesh] OR “Peripheral Catheterization” OR “Peripheral Catheterizations” OR “PICC” OR “Peripheral Arterial Catheterization”) AND (hand[mesh] OR hand[tiab] OR forearm[tiab])	4725
2.	("critical care"[MeSH Terms] OR "Intensive Care Units"[Mesh] OR "Emergency Service, Hospital"[Mesh] OR “critical care”[tiab] OR "Intensive Care”[tiab] OR Emergency[tiab])	512749
Intervention:
3.	"allen test" or "allen's test" OR "Ultrasonography, Doppler"[Mesh] OR doppler[tiab] OR “Pulse oximetry”[tiab] OR "Barbeau test"	144889
4.	(("Collateral Circulation"[Mesh] OR "Collateral Circulation"[tiab] OR “collateral blood supply”[tiab] OR “collateral blood circulation”[tiab] ) AND (hand[mesh] OR hand[tiab] OR forearm[tiab])) OR "Hand/blood supply"[Mesh] OR "Radius/blood supply"[Mesh] OR "Ulna/blood supply"[Mesh] OR "Radial Artery"[Mesh] OR "Radial Artery"[tiab]	18584
5.	"allen test" or "allen's test" OR "Barbeau test"	402
Outcome:
6.	(((Hand[tiab] OR "Hand"[Mesh]) AND (ischemia[tiab] OR "Ischemia"[Mesh] OR “ischaemic damage”[tiab])) OR Thrombosis[tiab] OR "Thrombosis"[Mesh] OR “blood clot”[tiab] OR “blood clots”[tiab] OR Embolism[tiab] OR "Embolism"[Mesh] OR “Radial artery thrombus”[tiab] OR “Digital embolization”[tiab] OR complications[tiab] OR complication[tiab])	1248610
Study type:
7.	Systematic[sb] OR "Meta-Analysis as Topic"[Mesh] OR "Systematic Reviews as Topic"[Mesh] OR systematic review[pt]	203261
Combined sets:
8.	1 AND 3	348
9.	1 AND 4	730
10.	2 AND 3 AND 7	55
11.	3 AND 6 AND 7	167
12.	5 OR 8 OR 9 OR 10 OR 11	1122
Final	12	1122

Embase via embase.com 210125

Allen test for assessment of blood circulation in the hand before insertion of an arterial catheter

	Search terms	Items found
The search result, usually found at the end of the documentation, forms the list of abstracts. /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase
Population:
1.	(cannulation OR cannulations OR catheter:ti,ab OR 'cannulation'/exp OR “Peripheral Catheterization” OR “Peripheral Catheterizations” OR “PICC” OR “Peripheral Arterial Catheterization”) AND ('hand'/exp OR hand:ti,ab OR forearm:ti,ab)	6083
2.	('intensive care'/exp OR 'intensive care unit'/exp OR 'hospital emergency service'/exp OR “critical care”:ti,ab OR "Intensive Care”:ti,ab OR Emergency:ti,ab)	1254485
Intervention:
3.	"allen test" or "allens test" OR 'Doppler ultrasonography'/exp OR doppler:ti,ab OR “Pulse oximetry”:ti,ab OR "Barbeau test"	193032
4.	(('collateral circulation'/exp OR "Collateral Circulation":ti,ab OR “collateral blood supply”:ti,ab OR “collateral blood circulation”:ti,ab ) AND ('hand'/exp OR hand:ti,ab OR forearm:ti,ab)) OR 'forearm blood flow'/exp OR 'radial artery'/exp OR "Radial Artery":ti,ab	19231
5.	"allen test" or "allens test" OR "Barbeau test"	401
Outcome:
6.	(((Hand:ti,ab OR 'hand'/exp) AND (ischemia:ti,ab OR 'ischemia'/exp OR “ischaemic damage”:ti,ab)) OR Thrombosis:ti,ab OR 'thrombosis'/exp OR “blood clot”:ti,ab OR “blood clots”:ti,ab OR Embolism:ti,ab OR 'embolism'/exp OR “Radial artery thrombus”:ti,ab OR “Digital embolization”:ti,ab OR complications:ti,ab OR complication:ti,ab)	1248610
Study type:
7.	'systematic review'/exp OR 'meta analysis'/exp OR 'Cochrane Library'/exp OR ((systematic* NEAR/3 review) or 'meta analy' or metaanaly):ab,ti,kw	474191
Combined sets:
8.	1 AND 3	394
9.	1 AND 4	731
10.	2 AND 3 AND 7	327
11.	3 AND 6 AND 7	489
12.	5 OR 8 OR 9 OR 10 OR 11
Final	12	2039

Cochrane Library via Wiley 210125

Allen test for assessment of blood circulation in the hand before insertion of an arterial catheter

	Search terms	Items found
The search result, usually found at the end of the documentation, forms the list of abstracts. au = Author; [mh…] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Population:
1.	(cannulation OR cannulations OR catheter:ti,ab OR [mh "Catheterization, Peripheral"] OR “Peripheral Catheterization” OR “Peripheral Catheterizations” OR “PICC” OR “Peripheral Arterial Catheterization”) AND ([mh hand] OR hand:ti,ab OR forearm:ti,ab)	782
2.	([mh "critical care"] OR [mh "Intensive Care Units"] OR [mh "Emergency Service, Hospital"] OR “critical care”:ti,ab OR "Intensive Care”:ti,ab OR Emergency:ti,ab)	44430
Intervention:
3.	"allen test":ti,ab or "allen's test":ti,ab OR [mh "Ultrasonography, Doppler"] OR doppler:ti,ab OR “Pulse oximetry”:ti,ab OR "Barbeau test":ti,ab	13002
4.	(([mh "Collateral Circulation"] OR "Collateral Circulation":ti,ab OR “collateral blood supply”:ti,ab OR “collateral blood circulation”:ti,ab ) AND ([mh "hand"] OR hand:ti,ab OR forearm:ti,ab)) OR [mh "Hand"/BS] OR [mh "Radius"/BS] OR [mh "Ulna"/BS] OR [mh "Radial Artery"] OR "Radial Artery":ti,ab	2076
5.	"allen test":ti,ab or "allen's test":ti,ab OR "Barbeau test":ti,ab	125
Outcome:
6.	(((Hand:ti,ab OR [mh "Hand"]) AND (ischemia:ti,ab OR [mh "Ischemia"] OR “ischaemic damage”:ti,ab)) OR Thrombosis:ti,ab OR [mh "Thrombosis"] OR “blood clot”:ti,ab OR “blood clots”:ti,ab OR Embolism:ti,ab OR [mh "Embolism"] OR “Radial artery thrombus”:ti,ab OR “Digital embolization”:ti,ab OR complications:ti,ab OR complication:ti,ab)	109973
Limits:
7.	Cochrane reviews
Combined sets:
8.	1 AND 3	61
9.	1 AND 4	74
10.	2 AND 3 AND 7	21
11.	3 AND 6 AND 7	36
12.	5 OR 8 OR 9 OR 10 OR 11	268
Final	12	268

Cinahl via ebsco 210125

Allen test for assessment of blood circulation in the hand before insertion of an arterial catheter

	Search terms	Items found
The search result, usually found at the end of the documentation, forms the list of abstracts. AB = Abstract; AU = Author; MH = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Population:
1.	(TI (cannulation OR cannulations OR catheter OR “Peripheral Catheterization” OR “Peripheral Catheterizations” OR “PICC” OR “Peripheral Arterial Catheterization”) OR AB (cannulation OR cannulations OR catheter OR “Peripheral Catheterization” OR “Peripheral Catheterizations” OR “PICC” OR “Peripheral Arterial Catheterization”) OR (MH "Catheterization, Peripheral+")) AND ((MH "Hand+") OR TI (hand OR forearm) OR AB (hand OR forearm))	949
2.	(MH "Critical Care+") OR (MH "Intensive Care Units+") OR (MH "Emergency Service+") OR TI (“critical care” OR "Intensive Care” OR Emergency) OR AB (“critical care” OR "Intensive Care” OR Emergency)	269003
Intervention:
3.	TX "allen test" OR TX "allen's test" OR (MH "Ultrasonography, Doppler+") OR TI doppler OR AB doppler OR TI “Pulse oximetry” OR AB “Pulse oximetry” OR TX "Barbeau test"	32300
4.	(((MH "Collateral Circulation") OR TI ("Collateral Circulation" OR “collateral blood supply” OR “collateral blood circulation”) OR AB ("Collateral Circulation" OR “collateral blood supply” OR “collateral blood circulation”)) AND ((MH "Hand+") OR TI (hand OR forearm) OR AB (hand OR forearm))) OR (MH "Hand/BS") OR (MH "Radius/BS") OR (MH "Ulna/BS") OR (MH "Radial Artery") OR TI "Radial Artery" OR AB "Radial Artery"	2714
5.	TX "allen test" OR TX "allen's test" OR TX "Barbeau test"	129
Outcome:
6.	(((MH "Hand+") OR TI (hand OR forearm) OR AB (hand OR forearm)) AND (TI (ischemia OR “ischaemic damage” OR Thrombosis OR “blood clot” OR “blood clots” OR Embolism OR “Radial artery thrombus” OR “Digital embolization” OR complications OR complication) OR AB (ischemia OR OR “ischaemic damage” OR Thrombosis OR “blood clot” OR “blood clots” OR Embolism OR “Radial artery thrombus” OR “Digital embolization” OR complications OR complication) OR (MH "Ischemia+") OR (MH "Thrombosis+") OR (MH "Embolism+")))	5858
Study type:
7.	(ZT "systematic review") OR (MH "systematic review") OR (TX "systematic review")	218831
Combined sets:
8.	1 AND 3	47
9.	1 AND 4	89
10.	2 AND 3 AND 7	42
11.	3 AND 6	172
12.	5 OR 8 OR 9 OR 10 OR 11	399
Final	12	399

Page published June 29, 2021

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