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Duplex Ultrasound Imaging of the Radial Artery

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Abstract

Radial artery duplex ultrasound diagnostics is used in a variety of patient-specific clinical scenarios. Clinical applications include the use to document anatomic changes of the radial artery in patients with hypertension, end-stage renal disease, and coronary artery disease. Radial artery duplex testing is used for preoperative mapping of the radial artery to determine suitability prior to harvesting for coronary artery bypass grafting and in conjunction with forearm muscle flaps. Testing is performed to verify adequate conduit diameter, free from disease, and to minimize the risk of hand ischemia after excision and ligation. Radial artery duplex imaging is also performed to assess suitability for transradial coronary interventions and to evaluate patency after cannulation. Upper extremity arterial duplex mapping is useful for dialysis access planning and used prior to construction of a radiocephalic arteriovenous fistula to exclude the use of the calcified or small caliber radial artery, parameters associated with maturation failure. This chapter details our protocol for radial artery duplex ultrasound testing.

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Author information

Authors and Affiliations

  1. Department of Vascular Surgery, Albany Medical College/Albany Medical Center Hospital, 391 Myrtle Ave., Suite 5, Albany, NY, 12208, USA

    Jeffrey C. Hnath MD, Courtney J. Warner MD, Sean P. Roddy MD & R. Clement Darling III MD

Authors
  1. Jeffrey C. Hnath MD
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  2. Courtney J. Warner MD
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  3. Sean P. Roddy MD
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  4. R. Clement Darling III MD
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Corresponding author

Correspondence to R. Clement Darling III MD .

Editor information

Editors and Affiliations

  1. Charleston, West Virginia, USA

    Ali F. AbuRahma

Review Questions

Review Questions

  1. 1.

    Which of the following statements regarding the technical aspects of radial artery duplex ultrasound testing is TRUE?

    1. a.

      A low-velocity scale assignment applied to color flow and duplex velocity scale decreases sensitivity.

    2. b.

      High-frequency transducers improve resolution of small, superficial vessels.

    3. c.

      For vein mapping, environmental considerations such as ambient room temperature are inconsequential.

    4. d.

      Beam steering is infrequently needed to improve color flow and Doppler signals.

  2. 2.

    Which is the strongest contraindication to radial artery harvest for CABG?

    1. a.

      History of Raynaud’s syndrome

    2. b.

      Incomplete superficial palmar arch

    3. c.

      Distant ulna fracture during childhood

    4. d.

      High origin of the radial artery

  3. 3.

    Which of the following statements regarding radial artery duplex ultrasound assessment is TRUE?

    1. a.

      Variation in palmar arch anatomy is relatively rare, occurring in 3–6% of the population.

    2. b.

      The Allen test is performed by compressing the radial artery alone to subjectively assess hand perfusion.

    3. c.

      The Allen test is considered the gold standard for assessing adequate hand perfusion by the ulnar artery.

    4. d.

      The duplex ultrasound Allen test uses the direction of flow in the superficial palmar arch to assess perfusion after radial artery compression.

Answer Key

  1. 1.

    b

  2. 2.

    b

  3. 3.

    d

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Hnath, J.C., Warner, C.J., Roddy, S.P., Clement Darling, R. (2017). Duplex Ultrasound Imaging of the Radial Artery. In: AbuRahma, A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-319-54760-2_31

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  • DOI: https://doi.org/10.1007/978-3-319-54760-2_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54758-9

  • Online ISBN: 978-3-319-54760-2

  • eBook Packages: MedicineMedicine (R0)

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