Adrenal Venous Sampling in Primary Hyperaldosteronism : Technical Success Rate at Maharat Nakhon Ratchasima Hospital
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Abstract
Background: Primary hyperaldosteronism is clinical consisted of hypertension, hypokalemia, and increased aldosterone production relative to suppressed plasma renin activity. The causes of primary hyperaldosteronism are most often bilateral adrenal hyperplasia or aldosterone-producing adenoma which require different treatment. Adrenal venous sampling (AVS) is an important tool to differentiate both forms of adrenal disease.
Objective: To evaluate the technical success rate of AVS procedure in patients with a clinical presentation of primary hyperaldosteronism
Methods: The study was retrospectively reviewed in all patients with clinical of primary hyperaldosteronism and underwent AVS, from April 2013 - July 2018.
Results: From April 2013- July 2018, 18 patients underwent AVS (6 men and 12 women, age 32-67 year-old). The success rate of venous sampling in bilateral adrenal veins was 66.7%. The technical success rates of AVS were 66.7% and 100% from the right adrenal vein and the left adrenal vein, respectively. In 5 of 12 patients with success right AVS, two different types of catheter were used. We performed intraprocedural cortisol measurement (IPCM) technique in 7 patients and the right adrenal vein was achieved in 5 patients within the second attempt using the resampling technique. No complication was occurred during and after the AVS procedure.
Conclusion: Adrenal venous sampling is a safe and increasingly utilized procedure in the evaluation of unilateral or bilateral adrenal disease. The success of the procedure can be improved by using a variety of catheters for right adrenal vein cannulation and IPCM with resampling technique.
Keywords: Primary hyperaldosteronism, Adrenal Venous Sampling (AVS)
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References
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