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C-Arm Computed Tomography-Assisted Adrenal Venous Sampling Improved Right Adrenal Vein Cannulation and Sampling Quality in Primary Aldosteronism

Authors
 Chung Hyun Park  ;  Namki Hong  ;  Kichang Han  ;  Sang Wook Kang  ;  Cho Rok Lee  ;  Sungha Park  ;  Yumie Rhee 
Citation
 Endocrinology and Metabolism (대한내분비학회지), Vol.33(2) : 236-244, 2018 
Journal Title
 Endocrinology and Metabolism (대한내분비학회지) 
ISSN
 2093-596X 
Issue Date
2018
Keywords
Adrenalectomy ; Cone-beam computed tomography ; Hyperaldosteronism ; Hypertension
Abstract
BACKGROUND: Adrenal venous sampling (AVS) is a gold standard for subtype classification of primary aldosteronism (PA). However, this procedure has a high failure rate because of the anatomical difficulties in accessing the right adrenal vein. We investigated whether C-arm computed tomography-assisted AVS (C-AVS) could improve the success rate of adrenal sampling. METHODS: A total of 156 patients, diagnosed with PA who underwent AVS from May 2004 through April 2017, were included. Based on the medical records, we retrospectively compared the overall, left, and right catheterization success rates of adrenal veins during the periods without C-AVS (2004 to 2010, n=32) and with C-AVS (2011 to 2016, n=124). The primary outcome was adequate bilateral sampling defined as a selectivity index (SI) >5. RESULTS: With C-AVS, the rates of adequate bilateral AVS increased from 40.6% to 88.7% (P<0.001), with substantial decreases in failure rates (43.7% to 0.8%, P<0.001). There were significant increases in adequate sampling rates from right (43.7% to 91.9%, P<0.001) and left adrenal veins (53.1% to 95.9%, P<0.001) as well as decreases in catheterization failure from right adrenal vein (9.3% to 0.0%, P<0.001). Net improvement of SI on right side remained significant after adjustment for left side (adjusted SI, 1.1 to 9.0; P=0.038). C-AVS was an independent predictor of adequate bilateral sampling in the multivariate model (odds ratio, 9.01; P<0.001). CONCLUSION: C-AVS improved the overall success rate of AVS, possibly as a result of better catheterization of right adrenal vein.
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DOI
10.3803/EnM.2018.33.2.236
Appears in Collections:
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
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Han, Ki Chang(한기창) ORCID logo https://orcid.org/0000-0002-9701-9757
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162650
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