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Adrenal venous sampling in primary aldosteronism: Experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register)

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Abstract

Objective

The aim of this study was to evaluate the rate of adrenal venous sampling (AVS) performance in patients with primary aldosteronism (PA), the main reasons for its non-performance, and the success and complications rate of this procedure in Spain. Moreover, the concordance between CT/MRI and AVS for PA subtyping was evaluated.

Methods

A retrospective multicenter study of PA patient follow-up in 20 Spanish tertiary hospitals between 2018–2021 was performed (SPAIN-ALDO Register).

Results

Of the 440 patients with PA included in the study, 153 underwent AVS (34.8%). The main reasons for not performing AVS were: patient rejection to the procedure, low catheterization rate in the center and unilateral disease based on CT/MRI. The overall success rate was 44.4% (the left adrenal vein was properly canulated in 77.8% and the right adrenal vein in 48.4%). Only 3 patients experienced minor complications. In the 45 patients with unilateral disease according to AVS, CT/MRI indicated bilateral disease or normal adrenal glands in 17. In the 23 patients with bilateral disease, CT/MRI indicated unilateral disease in 14. However, no significant differences were observed in biochemical response (P = 0.051) and hypertension resolution (P = 0.150) between patients who underwent surgery based on CT/MRI results and those who underwent surgery based on AVS results.

Conclusion

In our setting, AVS is still an underused technique in patients with PA. The low experience and success rate in AVS partially justify these results. More training for providers and patients needs to be done to include appropriate well performed AVS in the diagnosis algorithm of PA.

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Funding

This research was funded by Sociedad Española de Endocrinología y Nutrición (SEEN) https://www.seen.es/portal.

Author information

Authors and Affiliations

  1. Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Marta Araujo-Castro & Eider Pascual-Corrales

  2. University of Alcalá, Madrid, Spain

    Marta Araujo-Castro

  3. Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain

    Marta Araujo-Castro

  4. Endocrinology & Nutrition Department. OSI Bilbao-Basurto, Hospital Universitario de Basurto, Bilbao, Spain

    Miguel Paja Fano

  5. Basque Country University, Medicine Department, Bilbao, Spain

    Miguel Paja Fano

  6. Endocrinology & Nutrition Department, Hospital Universitario de Castellón, Castellón, Spain

    Marga González Boillos & Begoña Pla Peris

  7. Biochemistry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Ana María García Cano

  8. Endocrinology & Nutrition Department, Hospital Universitario La Paz Madrid, Madrid, Spain

    Paola Parra Ramírez & Patricia Martín Rojas-Marcos

  9. Endocrinology & Nutrition Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Jorge Gabriel Ruiz-Sanchez

  10. Endocrinology & Nutrition Department, Hospital Universitario de Toledo, Toledo, Spain

    Almudena Vicente Delgado

  11. Endocrinology & Nutrition Department, Hospital Universitario de Valladolid, Valladolid, Spain

    Emilia Gómez Hoyos

  12. Endocrinology & Nutrition Department, Hospital Universitario de La Princesa, Madrid, Spain

    Rui Ferreira

  13. General & Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain

    Iñigo García Sanz

  14. Endocrinology & Nutrition Department, Institut Català de la Salut Girona, Girona, Spain

    Mònica Recasens Sala & Rebeca Barahona San Millan

  15. Endocrinology & Nutrition Department, Hospital Universitario Virgen de la Victoria de Málaga. IBIMA, Malaga, Spain

    María José Picón César

  16. CIBEROBN, Madrid, Spain

    María José Picón César

  17. Endocrinology & Nutrition Department, Hospital Universitario Infanta Sofía, Madrid, Spain

    Patricia Díaz Guardiola

  18. Endocrinology & Nutrition Department, Hospital Universitario Virgen de la Macarena, Sevilla, Spain

    Juan Jesús García González

  19. Endocrinology & Nutrition Department, Clínica Universidad de Navarra, Pamplona, Spain

    Carolina M. Perdomo

  20. Endocrinology & Nutrition Department, Hospital Universitario Central de Asturias, Oviedo, Spain

    Laura Manjón Miguélez

  21. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain

    Laura Manjón Miguélez

  22. Endocrinology & Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain

    Rogelio García Centeno & Juan Carlos Percovich

  23. Endocrinology & Nutrition Department, Hospital Reina Sofía, Córdoba, Spain

    Ángel Rebollo Román

  24. Endocrinology & Nutrition Department, Hospital Rollo Villanueva, Zaragoza, Spain

    Paola Gracia Gimeno

  25. Endocrinology & Nutrition Department, Complejo Universitario de Salamanca, Salamanca, Spain

    Cristina Robles Lázaro

  26. Biochemistry and Molecular Genetics Department-CDB, Hospital Clinic. IDIBAPS, CIBERehd, Barcelona, Spain

    Manuel Morales-Ruiz

  27. Endocrinology & Nutrition Department. Hospital Clinic, Barcelona, Spain

    Felicia A. Hanzu

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  1. Marta Araujo-Castro
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Correspondence to Marta Araujo-Castro or Felicia A. Hanzu.

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The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the Hospital Universitario Ramón y Cajal. Madrid. Spain (approval date: 10th November 2020, code: ACTA 401)

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Patient consent was waived due to the retrospective nature of the study. Only for patients who continued follow-up or prospectively included the informed consent was requested.

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Araujo-Castro, M., Paja Fano, M., González Boillos, M. et al. Adrenal venous sampling in primary aldosteronism: Experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register). Endocrine 78, 363–372 (2022). https://doi.org/10.1007/s12020-022-03122-8

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