J Reconstr Microsurg 2009; 25(7): 399-403
DOI: 10.1055/s-0029-1220861
© Thieme Medical Publishers

The Lower-Extremity Allen Test

Nicholas T. Haddock1 , Evan S. Garfein2 , Pierre B. Saadeh1 , Jamie P. Levine1
  • 1New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
  • 2Montefiore Medical Center, Bronx, New York
Further Information

Publication History

Publication Date:
23 April 2009 (online)


The Allen test is used to diagnose the relative contribution of the ulnar and radial arteries to each hand. We modified this test to investigate the relative vascular contributions to distal perfusion of the lower extremity. With the patient supine, a handheld Doppler is used to locate the first dorsal metatarsal artery. The posterior tibial artery (PT) and dorsalis pedis artery (DP) pulses are compressed. A persistent signal indicates collateral flow through the peroneal artery (PA). Sequential decompression is then used to evaluate the relative contribution of the PT and DP to distal circulation. We report a case in which angiography failed to predict reliance on the PT. In this case, performance of the lower-extremity Allen test (LEAT) led to an alternative recipient vessel choice. The LEAT is simple to perform and provides a valuable adjunct to angiographic data.


Jamie P Levine, M.D. 

Institute of Reconstructive Plastic Surgery, New York University Medical Center

560 First Avenue—TCH-169, New York, NY 10016

Email: Jamie.Levine@nyumc.org