Assessing adequacy of collateral foot circulation

Q: How is the Allen's test performed for the dorsalis pedis artery?

Answer: – An Allen's test should be performed to assess the collateral circulation of the posterior tibialis if the dorsalis pedis artery is used for any purpose, such as obtaining Arterial Blood Gas (ABG) or inserting an arterial Line (A-Line).

It is tested by elevating the leg until the plantar skin blanches, then compressing the dorsalis pedis pulse with the thumb and lowering the leg to dependency. The foot should rapidly resume its normal color if the posterior tibial artery flow is adequate.

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References:

1. Haddock NT, Garfein ES, Saadeh PB, Levine JP. The lower-extremity Allen test. J Reconstr Microsurg. 2009 Sep;25(7):399-403. doi: 10.1055/s-0029-1220861. Epub 2009 Apr 23. PMID: 19391091.

2. Kaushal A, Verma S, Haldar R, Talawar P. Assessing adequacy of collateral foot circulation: A simple bedside test prior to lower extremity arterial cannulation. Saudi J Anaesth. 2020 Oct-Dec;14(4):552-554. doi: 10.4103/sja.SJA_75_20. Epub 2020 Sep 24. PMID: 33447211; PMCID: PMC7796736.