J Transcat Intervent.2021;29:eA20200037.
Clinical accuracy of reverse Barbeau test in the diagnosis of radial artery occlusion after transradial catheterization
Roberto Léo da Silva
, Paulo Felipe Romandini Britto
, Rodrigo de Moura Joaquim
, Pedro Beraldo de Andrade
, Alexandre Antonio Cunha Abizaid
, Filippe Barcelos Filippini
, Ramiro Granzziotin Vieira
, Renata Mirelli de Melo Viana
, Amanda Guera de Moraes Rego Sousa
, Fausto Feres
, José de Ribamar Costa Júnior
DOI: 10.31160/JOTCI202129A20200037
ABSTRACT
Background
Radial artery occlusion is an infrequent complication of transradial catheterization. Assessment of radial artery occlusion is a critical aspect of clinical care, and it should be done with an additional test, commonly by a plethysmographic test (reverse Barbeau test) or ultrasound (Doppler), the last is the gold standard. The objective of this study was to evaluate the accuracy of the reverse Barbeau test in detecting radial artery occlusion after transradial catheterization.
Methods
A study carried out in two centers encompassing patients submitted to procedures by radial access. All patients received at least 5,000IU of heparin. Sheaths were immediately removed after the procedure, using a patent hemostasis protocol. Patency of the radial artery was verified by reverse Barbeau test and duplex Doppler evaluation within the first 24 hours.
Results
A total of 350 patients were enrolled, with a mean age of 61.7 (±9.7) years. Radial artery occlusion was verified after the procedure in 19 (5.4%) patients, using duplex Doppler scan. Application of reverse Barbeau test had the following results: 64.0% type A curve, 15.7% type B, 8.3% type C, and 12.0% type D (the last suggesting occlusion). With reverse Barbeau test, patients with confirmed occlusion by ultrasound evaluation, 21.1% would be missed by a false-negative test, and in the ones, without radial artery occlusion, 8.2% would be misdiagnosed as having it (sensibility 78.9%; specificity 91.8%).
Conclusion
Reverse Barbeau test has good accuracy to detect radial artery occlusion, and it is a good option for clinical day use, although using reverse Barbeau test results in the overestimation of radial artery occlusion.
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