A Novel Method of Adrenal Venous Sampling via an Antecubital Approach

Jiang, Xiongjing; Dong, Hua; Peng, Meng; Che, Wuqiang; Zou, Yubao; Song, Lingyun; Zhang, Huimin; Wu, Haiying

doi:10.1007/s00270-016-1524-x

Cited by 15 publications

(24 citation statements)

References 18 publications

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“…The left adrenal vein arises from the anterior surface of the gland and joins the left inferior phrenic vein before draining into the left renal vein (63). Some anatomical variations have been described: a common trunk between the right adrenal vein and an accessory hepatic vein in 8% of the cases, while in 10% it is multiple.…”

Section: Patient Preparation and Techniquementioning

confidence: 99%

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Interventional radiology of the adrenal glands: current status

et al. 2018

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As more and more adrenal neoplasms are found incidentally or symptomatically, the need for interventional procedures has being increasing. In recent years these procedures registered continued steady expansion. Interventional radiology of the adrenal glands comprises angiographic and percutaneous procedures. They may be applied both in benign and in malignant pathologies. The present review reports the current status of indications, techniques results and complications of the image-guided procedures.

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Section: Patient Preparation and Techniquementioning

confidence: 99%

“…The jugular vein can be used if necessary. Recently, AVS via an antecubital approach was described in 190 patients as safe and feasible (63).…”

Section: Patient Preparation and Techniquementioning

confidence: 99%

Interventional radiology of the adrenal glands: current status

et al. 2018

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“…Traditionally, AVS has been performed via the femoral vein, with which the success rate of bilateral blood collection is reported to be about 31%‐82%. However, a study reported that the success rate of bilateral blood collection by AVS via the anterior cubital vein is 87.6% 20 . We therefore opted for the upper extremity route (median cubital vein or basilic vein).…”

Section: Methodsmentioning

confidence: 99%

Adrenal artery ablation for primary aldosteronism without apparent aldosteronoma: An efficacy and safety, proof‐of‐principle trial

Zhang

Liu

et al. 2020

J of Clinical Hypertension

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Primary aldosteronism (PA) is associated with resistant hypertension and cardiovascular events. There are some limitations of current medical and surgical therapies for PA. To determine the efficacy and safety of catheter‐based adrenal artery ablation for treatment of PA patients who refused both surgery and medical therapy, we performed this prospective cohort study. Thirty‐six PA patients without apparent aldosteronoma were treated by adrenal artery ablation. Primary outcome was postoperative blood pressure and defined daily dose (DDD) of antihypertensive medications after adrenal ablation. Secondary outcome was biochemical success. We assessed outcomes based on Primary Aldosteronism Surgical Outcome (PASO) criteria. Adrenal CT scan, biochemical evaluation, adrenal artery ablation and adrenal venous sampling (AVS) were underwent. After adrenal ablation, complete clinical success (normotension without antihypertensive medication) was achieved in 9/36 (25.0%) patients and partial clinical success (reduction in blood pressure or less antihypertensive medication) in 13/36 (36.1%) patients. Complete biochemical success (correction of hypokalemia and normalization of aldosterone‐to‐renin ratio) was achieved in 16/36 (44.4%) patients. Office‐based and ambulatory blood pressures were reduced by 17/7 and 11/2 mmHg at 6 months after ablation, respectively. The plasma cortisol level in the ablation group decreased slightly, but no patient developed hypoadrenocorticism. Catheter‐based adrenal ablation appears to produce substantial and sustained blood pressure reduction and biochemical improvement, with only minor adverse events in PA patients without apparent aldosteronoma. This therapy could be an important supplement for current PA treatments.

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“…The diagnosis of IHA was according to the standardized algorithm for the detection, confirmation, and subtype testing of PA according to the criteria of the 2008 Endocrine Society guidelines, 11 and all patients underwent computerized tomography and adrenal venous sampling to confirm IHA. 12 A lateralization index ≥2 was considered to indicate lateralization based on the results of adrenal venous sampling. The exclusion criteria were (a) other forms of secondary hypertension or APA, (b) an estimated glomerular filtration rate (based on the modification of diet in renal disease criteria) <45 ml/ min/1.73 m 2 , and/or serum creatinine >176 μmol/L, (c) hemorrhagic or ischemic stroke, and myocardial infarction within the previous 3 months, (d) percutaneous transluminal angiography received within the previous 3 months, and (e) allergy to iodinated contrast agent.…”

Section: Patient Populationmentioning

confidence: 99%

Superselective adrenal arterial embolization for idiopathic hyperaldosteronism: 12‐month results from a proof‐of‐principle trial

Dong

Zou

et al. 2021

Cathet Cardio Intervent

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Objectives: This study aimed to assess the safety, blood pressure changes, and biochemical responses of superselective adrenal artery embolization (SAAE) in hypertensive patients with idiopathic hyperaldosteronism (IHA).Background: SAAE is a minimally invasive procedure that has been used to successfully treat aldosterone-producing adenoma. However, its effect for patients with IHA is unevaluated.Methods: A total of 41 hypertensive patients who were diagnosed with IHA and underwent SAAE at the Fuwai Hospital between December 2010 and June 2016 were prospectively enrolled. The blood pressure, antihypertensive medications, plasma aldosterone and potassium levels, and adverse events were assessed. The primary endpoint was the change in home blood pressure at 12 months, compared with baseline.Results: SAAE was technically successful in 39 patients. Postoperatively, home and 24-hr mean blood pressures were reduced by 14/9 and 10/7 mmHg at 1 month, respectively, and by 13/7 and 11/7 mmHg at 12 months, respectively. The number of antihypertensive agents used reduced by 1.0 and 1.1 at 1 month and 12 months, respectively (all p < .001). Compared with baseline (524.0 pmol/L), the standing plasma aldosterone reduced to 293.4 pmol/L at 12 months (p < .001). Serum potassium increased from 3.0 to 4.1 mmol/L while the rate of potassium supplement and mineralocorticoid receptor antagonist use reduced from 87.1 and 89.7%, respectively, to 28.2 and 17.9%, respectively, at 12 months (all p < .001). There were no serious complications in the perioperative and 12-month follow-up periods.Conclusions: SAAE was effective and feasible for IHA treatment, without serious complications, therefore, maybe a potential treatment.

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A Novel Method of Adrenal Venous Sampling via an Antecubital Approach

Abstract: This study showed that AVS via an antecubital approach was safe and feasible, with a high rate of successful sampling.

Cited by 15 publications

References 18 publications

Interventional radiology of the adrenal glands: current status

Interventional radiology of the adrenal glands: current status

Adrenal artery ablation for primary aldosteronism without apparent aldosteronoma: An efficacy and safety, proof‐of‐principle trial

Superselective adrenal arterial embolization for idiopathic hyperaldosteronism: 12‐month results from a proof‐of‐principle trial

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