Computed tomography image fusion, Coaxial guidewire technique, Fast intraprocedural cortisol testing technique improves success rate and decreases radiation exposure, procedure time, and contrast use for adrenal vein sampling
- PMID: 34039913
- DOI: 10.1097/HJH.0000000000002852
Computed tomography image fusion, Coaxial guidewire technique, Fast intraprocedural cortisol testing technique improves success rate and decreases radiation exposure, procedure time, and contrast use for adrenal vein sampling
Abstract
Background: Adrenal vein sampling (AVS) is recommended for discriminating patients with unilateral primary aldosteronism from bilateral disease. However, it is a technically demanding procedure that is markedly underused. We developed a computed tomography image fusion, coaxial guidewire technique, fast intraprocedural cortisol testing (CCF) technique to improve AVS success rate, which combines CT image fusion, coaxial guidewire technique, and fast intraprocedural cortisol testing.
Objective: To evaluate the effectiveness and safety of the AVS--CCF technique.
Methods: We retrospectively evaluated 105 patients who undervent AVS from June 2016 to October 2020. There were 51 patients in the AVS--CCF group and 54 patients in the AVS group. We compared two groups with technical success rate, procedure time, radiation exposure, volume of contrast medium, and complications (adrenal vein rupture, dissection, infarction, or thrombosis; intraglandular or periadrenal hematoma; and contrast-induced nephropathy).
Results: The technical success rate was higher for AVS--CCF than for AVS without CCF (98 vs. 83.3% for bilateral adrenal veins, P = 0.016). AVS--CCF was associated with a shorter procedure time (63.6 ± 24.6 vs. 94.8 ± 40.8 min, P < 0.001), shorter fluoroscopy time (15.6 ± 12.6 vs. 20.4 ± 15.0 min, P = 0.043), and lower contrast medium volume (25.10 ± 21.82 vs. 44.1 ± 31.0 ml, P < 0.001). There were no significant differences between groups with respect to the time for cannulating the left or right adrenal vein or the peak skin radiation dose. Adrenal vein rupture occurred in 14 patients and intraglandular hematoma in 1 patient.
Conclusion: The CCF technique during AVS not only contributed to improved technical success rates but also associated with decreased procedure time, radiation exposure, and contrast medium volume.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Similar articles
-
Recent Advances in the Clinical Application of Adrenal Vein Sampling.Front Endocrinol (Lausanne). 2022 Feb 9;13:797021. doi: 10.3389/fendo.2022.797021. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 35222268 Free PMC article. Review.
-
Image Fusion Guidance with Pre-procedural CT with Real-Time Fluoroscopy for Adrenal Venous Sampling.Cardiovasc Intervent Radiol. 2018 Aug;41(8):1214-1222. doi: 10.1007/s00270-018-1930-3. Epub 2018 Mar 14. Cardiovasc Intervent Radiol. 2018. PMID: 29541836
-
Success Rate of Adrenal Venous Sampling and its Determining Factors: Experience of a Single Center in Malaysia.Ann Vasc Surg. 2024 Jan;98:258-267. doi: 10.1016/j.avsg.2023.08.021. Epub 2023 Oct 10. Ann Vasc Surg. 2024. PMID: 37820987
-
Intraprocedural Cortisol Measurement Increases Adrenal Vein Cannulation Success Rate in Primary Aldosteronism: A Systematic Review and Meta-analysis.Am J Hypertens. 2024 Jan 16;37(2):134-142. doi: 10.1093/ajh/hpad089. Am J Hypertens. 2024. PMID: 37777871
-
Comparison of C-arm computed tomography and on-site quick cortisol assay for adrenal venous sampling: A retrospective study of 178 patients.Eur Radiol. 2017 Dec;27(12):5006-5014. doi: 10.1007/s00330-017-4930-9. Epub 2017 Jul 4. Eur Radiol. 2017. PMID: 28677050
Cited by
-
Recent Advances in the Clinical Application of Adrenal Vein Sampling.Front Endocrinol (Lausanne). 2022 Feb 9;13:797021. doi: 10.3389/fendo.2022.797021. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 35222268 Free PMC article. Review.
-
Effect of Intraprocedural Cortisol Measurement on ACTH-stimulated Adrenal Vein Sampling in Primary Aldosteronism.J Endocr Soc. 2022 Jul 26;6(9):bvac104. doi: 10.1210/jendso/bvac104. eCollection 2022 Sep 1. J Endocr Soc. 2022. PMID: 35928241 Free PMC article.
-
Adrenal Vein Sampling for Primary Aldosteronism: Recommendations From the Australian and New Zealand Working Group.Clin Endocrinol (Oxf). 2025 Jan;102(1):31-43. doi: 10.1111/cen.15139. Epub 2024 Oct 3. Clin Endocrinol (Oxf). 2025. PMID: 39360599 Free PMC article. Review.
-
Preoperative supine time for adrenal venous sampling: a prospective randomized controlled trial.Trials. 2024 Jan 2;25(1):14. doi: 10.1186/s13063-023-07872-2. Trials. 2024. PMID: 38167540 Free PMC article. Clinical Trial.
-
Comparative Analysis of Single-Path and Multipath Adrenal Venous Sampling in Primary Aldosteronism.J Interv Cardiol. 2023 Aug 12;2023:8670365. doi: 10.1155/2023/8670365. eCollection 2023. J Interv Cardiol. 2023. PMID: 37601238 Free PMC article. Clinical Trial.
References
-
- Rossi GP. Primary aldosteronism: JACC state-of-the-art review. J Am Coll Cardiol 2019; 74:2799–2811.
-
- Monticone S, Burrello J, Tizzani D, Bertello C, Viola A, Buffolo F, et al. Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice. J Am Coll Cardiol 2017; 69:1811–1820.
-
- Calhoun DA, Nishizaka MK, Zaman MA, Thakkar RB, Weissmann P. Hyperaldosteronism among black and white subjects with resistant hypertension. Hypertension 2002; 40:892–896.
-
- Rossi GP, Bisogni V, Bacca AV, Belfiore A, Cesari M, Concistre A, et al. The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism. Int J Cardiol Hypertens 2020; 5:100029.
-
- Seccia TM, Letizia C, Muiesan ML, Lerco S, Cesari M, Bisogni V, et al. Atrial fibrillation as presenting sign of primary aldosteronism: results of the Prospective Appraisal on the Prevalence of Primary Aldosteronism in Hypertensive (PAPPHY) Study. J Hypertens 2020; 38:332–339.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical