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How To Do The Barbeau Test

Endovascular specialist Dr. Christopher Beck demonstrates how to do the Barbeau Test, a quick way to determine if a patient is a candidate for radial access. Radial access has become increasingly popular with interventional radiology procedures and is particularly helpful with certain patient populations who may have femoral arteries which are difficult to access because of atherosclerotic disease, body habitus or existing groin infection. The Barbeau Test is an important technique to assess patency of the radiopalmar arch. Understanding the patient’s circulation will aid in the decision making process of choosing the appropriate access site for the procedure.

How to Perform the Barbeau Test

1. Start with a pulse oximeter on the patient’s index finger and then compress the radial and ulnar arteries at the same time.
2. Once the waveform is flat for two cycles, release the ulnar artery.
3. In the next two minutes, watch for the waveform to return, at this point, the Barbeau Test is complete.

Barbeau Test Results

The Barbeau Test is used to classify radial artery compression patterns into one of four categories:
Type A: No damping of pulse tracing immediately after compression
Type B: Damping of pulse tracing
Type C: Loss of pulse tracing followed by recovery of pulse tracing within 2 minutes
Type D: Loss of pulse tracing without recovery within 2 minutes

Using the Barbeau Test to Inform Radial Artery Access

Application of the Barbeau Test varies in practice. Some operators suggest performing radial access in only Barbeau A, B and C patterns. Some interventionalists advocate that all Barbeau patterns are candidates for radial access, and some operators forego the Barbeau test entirely and move forward with radial access regardless. The Barbeau test can be used to better understand the patient’s circulation, but is just one tool in the assessment for radial access.

Learn more on the BackTable VI Podcast

BackTable is a knowledge resource for physicians by physicians. Get practical advice on Radial Access and how to build your practice by listening to the BackTable VI Podcast.

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Ep 148 Radial vs. Femoral for Prostate Artery Embolization with Dr. Blake Parsons
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