Recent Advances in the Clinical Application of Adrenal Vein Sampling

Zhong, Shan; Zhang, Tianyue; He, Minzhi; Yu, Han-xiao; Liu, Zhenjie; Li, Zhongyi; Song, Xiaoxiao; Xu, Xiaohong

doi:10.3389/fendo.2022.797021

Cited by 5 publications

(4 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Adrenal venous sampling (AVS) was now regarded as the gold standard for P.A. subtyping but only performed in limited centers [ 12 , 14 ]. Our team was experienced in this technique.…”

Section: Introductionmentioning

confidence: 99%

Preoperative supine time for adrenal venous sampling: a prospective randomized controlled trial

He,

Zhang,

Song

et al. 2024

Trials

Self Cite

View full text Add to dashboard Cite

Background Primary aldosteronism (P.A.) is the most common form of secondary hypertension, accounting for 5% of hypertensive patients and 17–23% of patients with resistant hypertension. Compared to primary hypertension, P.A. is more prone to cause severe organ damage and even early death. Adrenal venous sampling (AVS) is a practical confirmatory test for subtyping aldosterone-producing adenoma and bilateral adrenal hyperplasia, helping physicians to make an accurate decision between surgery or medication. According to guidelines, supine in bed before AVS is recommended for a desirable result of AVS. However, investigations about the most optimal preoperative supine time before AVS are lacking. Methods/design This is a multi-center prospective randomized controlled study. One hundred twenty patients diagnosed as P.A. and willing for AVS examination will be included. Participants will be randomly allocated to a 15-min supine time group or 2-h supine time group. The primary outcome is the degree of biochemical remission (serum potassium and orthostatic ARR). The secondary outcomes are degrees of clinical remission (blood pressure, type and dose of antihypertensive drugs), the technical success rate, and the adverse event of AVS (selective index ≥ 2 is considered successful surgery without corticotropin stimulation). Discussion P.A. is an intractable public health problem, and many techniques including AVS have been developed to identify this disease correctly. This study will help to understand whether the length of preoperative supine time would affect the diagnostic efficacy of AVS and thus help to formulate a more reasonable AVS procedure. Trial registration ClinicalTrials.gov NCT05658705. Registered on 10 September 2022.

show abstract

“…Adrenal venous sampling (AVS) was now regarded as the gold standard for P.A. subtyping but only performed in limited centers [ 12 , 14 ]. Our team was experienced in this technique.…”

Section: Introductionmentioning

confidence: 99%

Preoperative supine time for adrenal venous sampling: a prospective randomized controlled trial

He,

Zhang,

Song

et al. 2024

Trials

Self Cite

View full text Add to dashboard Cite

show abstract

“…Subtyping test is also an essential, although difficult and challenging, step 13 . Adrenal venous sampling (AVS) was now regarding as the gold standard for PA subtyping but only performed in several professional centers 12,14 . Our team was experienced in this technique.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Supine Time for Adrenal Venous Sampling: A Prospective Randomized Controlled Trial

Liu

Zhang

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Primary aldosteronism (PA) is the most common form of secondary hypertension, accounting for 5% of hypertensive patients and 17-23% in patients with resistant hypertension. Compared to the primary hypertension, PA is more prone to cause severe organ damage and even early death. Adrenal venous sampling (AVS) is an effective confirmatory test for subtyping unilateral and bilateral adrenal hyperplasia, helping physicians to make an accurate decision between surgery or medication to treat PA. Supine in bed before AVS is recommended for a desirable result of AVS according to guidelines. However, investigating study about the most optimal preoperative supine time before AVS is lacking. Methods/design: This is a single-center prospective randomized controlled study. 120 patients diagnosed as PA and with willing for further AVS examination will be included. Participants will be randomly allocated to 15-min supine time group or 2-hours supine time group. The primary outcome is the degree of biochemical remission (serum potassium and orthostatic ARR). The secondary outcomes are degree of the clinical remission (blood pressure, type and dose of antihypertensive drugs), the technical success rate and the adverse event of AVS (selective index≥2 is considered as successful surgery without corticotropin stimulate). Discussion: PA is an intractable public health problem, and many techniques including AVS have been developed to correctly identify this disease. This study will help to understand whether the length of preoperative supine time would affect the diagnostic efficacy of AVS, and thus help to formulate a more reasonable AVS procedure. Trial registration: ClinicalTrials.gov, ID: NCT05658705. Registered on 10 September 2022.

show abstract

“…As several guidelines recommend, adrenal venous sampling (AVS) is considered the gold standard for differentiating APA from BAH [4,5]. However, the AVS technique is challenging, given a success rate of 60-90% [6,7]. The main difficulty associated with AVS is the cannulation of the right adrenal vein (RAV), as it is often short and exhibits several anatomical variations [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Cone-beam computed tomography is not a mandatory procedure in adrenal venous sampling for primary hyperaldosteronism

Cai

2022

BMC Med Imaging

View full text Add to dashboard Cite

Objectives To investigate the necessity of cone-beam computed tomography (CBCT) in adrenal venous sampling (AVS). Methods This retrospective study included 120 consecutive patients with primary hyperaldosteronism who underwent AVS. Based on the learning curve of the interventional radiologists, the patients were divided into the learning (n = 36) and proficiency (n = 84) groups chronologically. Based on the imaging pattern of the right adrenal vein (RAV), the patients were divided into the typical (n = 36) and atypical (n = 84) groups. The success rate, radiation dose, and sampling time were compared among the entire study population and each subgroup. Results A total of 69 patients underwent CBCT, whereas 51 patients did not. The overall success rate was 85.8%, and no difference was noted between patients with and without CBCT (P = 0.347). However, radiation dose (P = 0.018) and sampling time (P = 0.001) were significantly higher in patients who underwent CBCT than in patients who did not. In learning group, CBCT improved success rate from 62.5 to 96.4% (P = 0.028), whereas it was not found in the proficiency group (P = 0.693). Additionally, success rate in patients with an atypical RAV imaging pattern was significantly higher when CBCT was used than when it was not used (P = 0.041), whereas no difference was noted in patients with typical RAV imaging pattern (P = 0.511). Conclusion For physicians not very experienced doing AVS, there is a clear significant improvement in success rate when CBCT is used. However, CBCT only has minimal benefit for experienced operators, meanwhile CBCT may take an extra time and increase the radiation dose during AVS.

show abstract

Recent Advances in the Clinical Application of Adrenal Vein Sampling

Cited by 5 publications

References 51 publications

Preoperative supine time for adrenal venous sampling: a prospective randomized controlled trial

Preoperative supine time for adrenal venous sampling: a prospective randomized controlled trial

Preoperative Supine Time for Adrenal Venous Sampling: A Prospective Randomized Controlled Trial

Cone-beam computed tomography is not a mandatory procedure in adrenal venous sampling for primary hyperaldosteronism

Contact Info

Product

Resources

About