TY - JOUR
T1 - Non-invasive assessment of the collateral circulation in the hand
T2 - Validation of the Nexfin system and relation to clinical outcome after transradial catheterisation
AU - Hollander, Maurits R.
AU - Van Leeuwen, Maarten A.H.
AU - Van Der Heijden, Dirk J.
AU - Keizer, Vincent M.N.
AU - Van De Ven, Peter M.
AU - IJsselmuiden, Sander J.J.
AU - Van Mieghem, Nicolas M.
AU - Amoroso, Giovanni
AU - Ritt, Marco J.P.F.
AU - Knaapen, Paul
AU - Van Royen, Niels
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Aims: This study aims primarily to assess the extent of the collateral circulation of the hand in a combined population of healthy individuals and patients who underwent transradial catheterisation, using both the Nexfin system and laser Doppler perfusion imaging. Methods and results: In total, 85 adults were included in the study (18 healthy volunteers; 67 patients who underwent transradial catheterisation). The perfusion of the thumb was assessed prior to and during complete radial artery compression using laser Doppler perfusion imaging (LDPI) and the Nexfin system. The palmar collateral flow index (PCFI) was compared between both devices and PCFINEXFIN was related to hand angiography and the upper limb function, using the QuickDASH questionnaire. Mean PCFILDPI was 0.77±0.15 and mean PCFINEXFIN was 0.88±0.08. Both were significantly related (Pearson correlation=0.49, 95% CI: 0.31-0.64, p<0.001, agreement-0.11±0.13). PCFINEXFIN correlated with the maximal diameter of the superficial palmar arch (R=0.49, p=0.04) and total minimal arch diameter (R=0.51, p<0.02). High PCFINEXFIN, measured at baseline, was correlated with a lower QuickDASH score for pain, activity and total at one month post transradial catheterisation (p=0.02, p<0.01, p<0.01), but not with discomfort or disability. Conclusions: The Nexfin monitoring system is comparable with laser Doppler perfusion imaging in the quantification of the collateral perfusion in the hand. In patients, the Nexfin-derived collateral flow index measured at baseline is associated with clinical outcome at 30 days post transradial catheterisation.
AB - Aims: This study aims primarily to assess the extent of the collateral circulation of the hand in a combined population of healthy individuals and patients who underwent transradial catheterisation, using both the Nexfin system and laser Doppler perfusion imaging. Methods and results: In total, 85 adults were included in the study (18 healthy volunteers; 67 patients who underwent transradial catheterisation). The perfusion of the thumb was assessed prior to and during complete radial artery compression using laser Doppler perfusion imaging (LDPI) and the Nexfin system. The palmar collateral flow index (PCFI) was compared between both devices and PCFINEXFIN was related to hand angiography and the upper limb function, using the QuickDASH questionnaire. Mean PCFILDPI was 0.77±0.15 and mean PCFINEXFIN was 0.88±0.08. Both were significantly related (Pearson correlation=0.49, 95% CI: 0.31-0.64, p<0.001, agreement-0.11±0.13). PCFINEXFIN correlated with the maximal diameter of the superficial palmar arch (R=0.49, p=0.04) and total minimal arch diameter (R=0.51, p<0.02). High PCFINEXFIN, measured at baseline, was correlated with a lower QuickDASH score for pain, activity and total at one month post transradial catheterisation (p=0.02, p<0.01, p<0.01), but not with discomfort or disability. Conclusions: The Nexfin monitoring system is comparable with laser Doppler perfusion imaging in the quantification of the collateral perfusion in the hand. In patients, the Nexfin-derived collateral flow index measured at baseline is associated with clinical outcome at 30 days post transradial catheterisation.
KW - Access-site complication
KW - Non-invasive imaging
KW - Radial access
KW - Risk stratification
UR - http://www.scopus.com/inward/record.url?scp=85016080676&partnerID=8YFLogxK
U2 - https://doi.org/10.4244/EIJ-D-16-00337
DO - https://doi.org/10.4244/EIJ-D-16-00337
M3 - Article
C2 - 27725319
SN - 1774-024X
VL - 12
SP - 1773
EP - 1781
JO - Eurointervention
JF - Eurointervention
IS - 14
ER -