Adrenal vein sampling for primary aldosteronism

ǂa ǂ15-year national referral center experience

Tomaž Kocjan (Author), Mojca Jensterle Sever (Author), Gaj Vidmar (Author), Rok Vrčkovnik (Author), Pavel Berden (Author), Milenko Stankovič (Author)

Abstract

Background Adrenal vein sampling (AVS) is essential for diagnostics of primary aldosteronism, distinguishing unilateral from bilateral disease and determining treatment options. We reviewed the performance of AVS for primary aldosteronism at our center during first 15 years, comparing the initial period to the period after the introduction of a dedicated radiologist. Additionally, AVS outcomes were checked against CT findings and the proportion of operated patients with proven unilateral disease was estimated. Patients and methods A retrospective cross-sectional study conducted at the national endocrine referral center included all patients with primary aldosteronism who underwent AVS after its introduction in 2004 until the end of 2018. AVS was performed sequentially during Synacthen infusion. When the ratio of cortisol concentrations from adrenal vein and inferior vena cava was at least 5, AVS was considered successful. Results Data from 235 patients were examined (168 men; age 32%73, median 56 years; BMI 18%48, median 30.4 kg/ m2). Average number of annual AVS procedures increased from 7 in the 2004%2011 period to 29 in the 2012%2018 period (p < 0.001). AVS had to be repeated in 10% of procedures; it was successful in 77% of procedures and 86% of patients. The proportion of patients with successful AVS (92% in 2012%2018 vs. 66% in 2004%2011, p < 0.001) and of successful AVS procedures (82% vs. 61%, p < 0.001) was statistically significantly higher in the recent period. Conclusions Number of AVS procedures and success rate at our center increased over time. Introduction of a dedicated radiologist and technical advance expanded and improved the AVS practice.

Keywords

angiography;adrenal gland;endocrine disorders;

Data

Language:	English
Year of publishing:	2020
Typology:	1.01 - Original Scientific Article
Organization:	OI - Institute of Oncology
Publisher:	Association of Radiology and Oncology
UDC:	616.4
COBISS:	27351043
ISSN:	1318-2099
Views:	46
Downloads:	25
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	Slovenian
Secondary keywords:	angiografija;nadledvična žleza;endokrine motnje;
Source comment:	Soavtorji: Mojca Jensterle, Gaj Vidmar, Rok Vrckovnik, Pavel Berden and Milenko Stankovic;
Pages:	str. 409-418, III
Volume:	ǂVol. ǂ54
Issue:	ǂno. ǂ4
Chronology:	2020
DOI:	10.2478/raon-2020-0052
ID:	24531084