Abstract
Purpose
This study was designed to evaluate retrospectively the efficacy of C-arm CT to confirm right adrenal vein catheterization during adrenal vein sampling (AVS) and to correlate adrenal venography findings with C-arm CT and/or biochemical results for right adrenal vein selection.
Methods
Forty-two consecutive primary aldosteronism patients (M:F = 21:21; age: 29–70 years) underwent C-arm CT assisted sequential AVS. After catheterization of right adrenal vein, C-arm CT was performed to confirm catheter position. Catheter was repositioned when right adrenal gland was not opacified. Radiological images, medical records, and biochemical results were reviewed for technical/biochemical success rates and complications. Right adrenal venography findings of pinnate pattern, visualization of renal capsular vein, and retroperitoneal vein other than renal capsular vein were correlated with C-arm CT and/or biochemical results for right adrenal vein selection.
Results
Both the technical and biochemical success of AVS was achieved in 40 patients (95.2 %). C-arm CT failed due to catheter instability in one, and adrenal/vena cava cortisol gradient was <3 in one patient. Catheter was repositioned in four patients (9.5 %) according to C-arm CT findings. Right adrenal venography finding of renal capsular vein significantly correlated with C-arm CT and/or biochemical results (100 %) for right adrenal vein selection (p = 0.011, χ 2 test), whereas pinnate pattern (p = 0.099) and other retroperitoneal veins (p = 0.347) did not. There was no procedure-related complication.
Conclusions
C-arm CT increases confidence of right adrenal vein catheterization during AVS. Visualization of renal capsular vein on adrenal venography suggests right adrenal vein catheterization and C-arm CT may not be required.
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Conflict of interest
Sung Il Park, Yumie Rhee, Jung Soo Lim, Sungha Park, Sang Wook Kang, Mu Sook Lee, Myungsu Lee, Shin Jae Lee, Il Jung Kim, Do Yun Lee, and June-Sik Cho have no conflict of interest to disclose.
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Park, S.I., Rhee, Y., Lim, J.S. et al. Right Adrenal Venography Findings correlated with C-arm CT for Selection During C-arm CT-assisted Adrenal Vein Sampling in Primary Aldosteronism. Cardiovasc Intervent Radiol 37, 1469–1475 (2014). https://doi.org/10.1007/s00270-013-0820-y
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DOI: https://doi.org/10.1007/s00270-013-0820-y