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Adrenal Vein Sampling for Conn's Syndrome: Diagnosis and Clinical Outcomes.

Authors
  • Deipolyi, Amy R1
  • Bailin, Alexander2
  • Wicky, Stephan3
  • Alansari, Shehab4
  • Oklu, Rahmi5
  • 1 Division of Vascular & Interventional Radiology, Department of Radiology, New York University Medical Center, New York, NY 10016, USA. [email protected]
  • 2 Massachusetts General Hospital, Harvard Medical School, Division of Interventional Radiology, 55 Fruit Street, GRB-290A, Boston, MA 02114, USA. [email protected]
  • 3 Massachusetts General Hospital, Harvard Medical School, Division of Interventional Radiology, 55 Fruit Street, GRB-290A, Boston, MA 02114, USA. [email protected]
  • 4 Massachusetts General Hospital, Harvard Medical School, Division of Interventional Radiology, 55 Fruit Street, GRB-290A, Boston, MA 02114, USA. [email protected]
  • 5 Massachusetts General Hospital, Harvard Medical School, Division of Interventional Radiology, 55 Fruit Street, GRB-290A, Boston, MA 02114, USA. [email protected]
Type
Published Article
Journal
Diagnostics
Publisher
MDPI AG
Publication Date
Jun 19, 2015
Volume
5
Issue
2
Pages
254–271
Identifiers
DOI: 10.3390/diagnostics5020254
PMID: 26854152
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management.

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