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Right adrenal venography findings correlated with C-arm CT for selection during C-arm CT-assisted adrenal vein sampling in primary aldosteronism.

 Sung Il Park  ;  Yumie Rhee  ;  Jung Soo Lim  ;  Sungha Park  ;  Sang Wook Kang  ;  Mu Sook Lee  ;  Myungsu Lee  ;  Shin Jae Lee  ;  Il Jung Kim  ;  Do Yun Lee  ;  June Sik Cho 
 Cardiovascular and Interventional Radiology, Vol.37(6) : 1469-1475, 2014 
Journal Title
 Cardiovascular and Interventional Radiology 
Issue Date
Adrenal Glands/blood supply* ; Adult ; Aged ; Catheterization ; Female ; Humans ; Hyperaldosteronism/blood* ; Male ; Middle Aged ; Phlebography/methods* ; Radiography, Abdominal ; Radiography, Interventional* ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods*
Hyperaldosteronism ; Hypertension ; Adrenal vein sampling ; C-arm CT ; Catheterization
PURPOSE: This study was designed to evaluate retrospectively the efficacy of C-arm CT to confirm right adrenal vein catheterization during adrenal vein sampling (AVS) and to correlate adrenal venography findings with C-arm CT and/or biochemical results for right adrenal vein selection. METHODS: Forty-two consecutive primary aldosteronism patients (M:F = 21:21; age: 29-70 years) underwent C-arm CT assisted sequential AVS. After catheterization of right adrenal vein, C-arm CT was performed to confirm catheter position. Catheter was repositioned when right adrenal gland was not opacified. Radiological images, medical records, and biochemical results were reviewed for technical/biochemical success rates and complications. Right adrenal venography findings of pinnate pattern, visualization of renal capsular vein, and retroperitoneal vein other than renal capsular vein were correlated with C-arm CT and/or biochemical results for right adrenal vein selection. RESULTS: Both the technical and biochemical success of AVS was achieved in 40 patients (95.2%). C-arm CT failed due to catheter instability in one, and adrenal/vena cava cortisol gradient was <3 in one patient. Catheter was repositioned in four patients (9.5%) according to C-arm CT findings. Right adrenal venography finding of renal capsular vein significantly correlated with C-arm CT and/or biochemical results (100%) for right adrenal vein selection (p = 0.011, χ(2) test), whereas pinnate pattern (p = 0.099) and other retroperitoneal veins (p = 0.347) did not. There was no procedure-related complication. CONCLUSIONS: C-arm CT increases confidence of right adrenal vein catheterization during AVS. Visualization of renal capsular vein on adrenal venography suggests right adrenal vein catheterization and C-arm CT may not be required.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Kim, Il Jung(김일중)
Park, Sung Il(박성일)
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Lee, Do Yun(이도연)
Lee, Shin Jae(이신재)
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
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