Comparison of the Central Adrenal Vein and the Common Trunk of the Left Adrenal Vein for Adrenal Venous Sampling

Takada, Akira; Suzuki, Kôjiro; Mori, Yasuki; Hyodo, Ryota; Kawakami, Keisuke; Okochi, Yoshiyuki; Naganawa, Shinji

doi:10.1016/j.jvir.2013.01.007

Cited by 17 publications

(14 citation statements)

References 27 publications

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“…Takada et al also reported higher plasma cortisol and aldosterone levels from the left CAV than from the left common trunk when using a 5-French catheter for common trunk sampling and a 2.8-French microcatheter for CAV sampling. They reported a median cortisol level of 129 μg/dL in the common trunk and a level of 215 μg/dL in the CAV [5] and the changing rate were similar to our result in group A (277 μg/dL and 585 μg/ dL, respectively). Although this difference was significantly reduced in our study when a microcatheter was used for common trunk sampling in group B (532 μg/dL and 640 μg/dL, respectively).…”

Section: Discussionsupporting

confidence: 90%

“…microcatheters have generally been used for sampling the CAV, but not for sampling the common trunk without effective control of blood withdrawing speed using larger catheters [5]. Furthermore, sampling results were analyzed based only on the aldosterone to cortisol ratio (A/C ratio), with the assumption of constantly symmetrical cortisol secretion in PA patients.…”

Section: Avsmentioning

confidence: 99%

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Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion

et al. 2017

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Section: Discussionsupporting

confidence: 90%

Section: Avsmentioning

confidence: 99%

Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion

et al. 2017

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“…As expected, the SI was significantly lower on the left side, which results from the LAV anatomy that joins the inferior phrenic vein forming a common trunk where the catheter is usually placed and aspirates diluted blood. Previous reports indicated that selective cannulation of the LAV does not provide additional benefit [24,25]. The selectivity indices were remarkably high because all procedures were performed during cosyntropin infusion.…”

Section: Discussionmentioning

confidence: 95%

A single-centre experience of the implementation of adrenal vein sampling procedure: the impact on the diagnostic work-up in primary aldosteronism

et al. 2017

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A b s t r a c tBackground: Primary aldosteronism is one of the most common causes of secondary hypertension. Adrenal vein sampling (AVS) remains a "gold standard" procedure in differentiation between unilateral (adenoma) and bilateral (hyperplasia) disease. Aim:The aim of this study was to present our single-centre experience in establishing and implementating the AVS procedure. Methods:All patients had primary aldosteronism confirmed in a salt-infusion test. AVS was performed sequentially during a continuous intravenous infusion of cosyntropin and was preceded by multislice contrast-enhanced computed tomography (CT) examination of adrenal glands performed a few weeks before AVS in the majority of patients. AVS was regarded as successful if the ratio of each adrenal vein cortisol to inferior vena cava cortisol levels (selectivity index [SI]) was higher than 3.0. In the case of failure, a second attempt was considered in a few weeks. Patients were divided into four groups according to the order of the procedure by quartiles.Results: Between 31 May, 2012 and 5 May, 2016, AVS was performed in 124 patients (69% males, aged 55.3 ± 10.3 years) and was successful in 120 (96.8%) patients. All failed cases were due to the failure of cannulation of the right adrenal vein. The first-attempt success rate was 94.3% (117 of 124 patients) and increased from 83.9% in the first 31 patients to 100% in the last 31 patients. Similarly, the overall success rate increased from 93.5% to 100%. The right SI was significantly higher than the left one (26.4 vs. 11.0, p < 0.0001). Both indices did not differ across quartiles of patients. No complications occurred during the procedure. Conclusions:The AVS procedure, preceded by adrenal CT, may be implemented into daily diagnostic practice safely with an excellent success rate.

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“…It has been assumed that blood from the central vein may more accurately reflect the aldosterone secretion rate from the adrenal gland and/or adrenal tumour. Takada et al . have reported that the absolute aldosterone and cortisol concentrations in a small cohort were significantly higher in the central vein than in the common trunk, although the aldosterone/cortisol ratios were similar in the two sites.…”

Section: Introductionmentioning

confidence: 96%

Optimum position of left adrenal vein sampling for subtype diagnosis in primary aldosteronism

Umakoshi

Wada

Ichijo

et al. 2015

Clinical Endocrinology

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show abstract

Comparison of the Central Adrenal Vein and the Common Trunk of the Left Adrenal Vein for Adrenal Venous Sampling

Cited by 17 publications

References 27 publications

Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion

Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion

A single-centre experience of the implementation of adrenal vein sampling procedure: the impact on the diagnostic work-up in primary aldosteronism

Optimum position of left adrenal vein sampling for subtype diagnosis in primary aldosteronism

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