Keywords:
Interventional vascular, Veins / Vena cava, Abdomen, Catheter venography, CT-Angiography, Catheters, Venous access, Endocrine disorders, Metabolic disorders
Authors:
R. Britel, P. Roig Egea, J. M. Martinez Riutort, C. Nieto Garcia, D. A. Torres Gamboa, M. A. Martin Martin, A. Hernaez Garcia de la Torre ; Palma de Mallorca/ES
DOI:
10.26044/ecr2019/C-3504
Results
Between January 2009 and August 2018,
adrenal vein sampling was performed in 37 patients (88% men,
12% women; mean age: 60,4 years; minimum age: 40 years; maximum age: 74 years.
(Figure 3).
The adrenal vein sampling success rate was 97% (36 of 37) with the only failed intervention was due to cannulation failure of the right adrenal vein.
Figure 11,
12,
13,
14,
16,
17 and 18 shows the main difficulties in the adrenal vein sampling.
No patient had a contraindication to the procedure (Iodinated contrast allergy,
decubitus intolerance and / or stimulation,
impossibility to obtain venous access,
etc). None of the patients experienced severe complications.
Adrenal vein sampling showed 68% of cases of lateralization,
27% of non-lateralization and 5% of inconclusive cases.
in the patient group with laterization (25 patients),
18 were operated.
(Figure 19) Following the unilateral adrenectomía full,
partial or absent clinical success was evaluated according to a set of standard criteria based on the blood pressure and the use of antihypertensive drugs (Lancet according Endocrinol Diabetes.
2017).
All patients presented a clinical response,
with a complete clinical response rate of 18.2% and a partial clinical response rate of 81.8%.
(Figure 20)
Adrenal vein sampling is essential when considering surgery even if the patient has a CT/MRI with a unilateral macronodule.
- CT / MR error rate = 35% compared to adrenal vein sampling.
- 20% of patients with unilateral hypersecretion have a normal CT scan or bilateral lesions.
- 25% of patients with bilateral hypersecretion have a unilateral nodule.