Abstract
Adrenal vein sampling (AVS) is performed to determine if there is unilateral or bilateral hypersecretion of aldosterone in patients with primary hyperaldosteronism. The procedure can be technically challenging in large part due to anatomy of the adrenal veins, with the right adrenal vein being more challenging than the left for localization and catheterization. The purpose of this study is to determine the whether reviewing a preprocedural diagnostic computed tomography (CT) improves the technical outcomes of an AVS procedure. 76 patients who underwent adrenal vein sampling performed by a single operator at one institution were retrospectively analyzed. Patients were divided into two groups, group 1 who had a preprocedural CT available for review at the time of the AVS procedure, and group 2 who had no preprocedural CT available at the time of the AVS. The two groups were compared on the following basis: technical success of the procedure, as defined by successful localization and sampling of the adrenal veins, overall time of the procedure, contrast load, and fluoroscopy time. Out of the 76 AVS cases reviewed, 37 (49%) had a preprocedural CT available at the time of the AVS, and 39(51%) did not. The technical success rate for group 1 was 100%, compared to 92% for group 2. The mean procedural time for group 1 was 63 minutes compared to 67 minutes for group 2, not statistically significant. The mean fluro time for group 1 was 13.7 minutes compared to 15.1 minutes for group 2, not statistically significant. The mean contrast load given for group 1 was 61 cc compared with 57 cc for group 2, not statistically significant. AVS can be technically challenging due to the anatomy and difficulty in localization of the right greater than the left adrenal vein. The availability of a preprocedural CT for planning purposes has not been evaluated fully. Based on our data, preprocedural diagnostic CT does not result in improved technical outcome of adrenal vein sampling.
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