Before Cannulation of the Radial Artery: Collateral Arterial Supply Evaluated by Strain-Gauge Plethysmography

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Abstract
Systolic arterial pressure in the thumb was measured using strain-gauge plethysmography before and after compression of the radial artery in 259 patients (aged 11-75 yr) undergoing vascular or open-heart surgery. In 38 hands (in 27 patients aged 37-75 yr) manual compression of the radial artery reduced the arterial pressure in the thumb to < 40 mm Hg (5.3 kPa [luto pascal unit]), and, consequently, the collateral ulnar arterial supply was inadequate. Because 27 of 259 patients (10.4%) would be without adequate blood supply to 1 or both thumbs following occlusion of the radial arteries, cannulation of the radial artery should be performed only after ensuring the presence of an adequate collateral ulnar arterial supply.

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