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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
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Failure mode analysis in adrenal vein sampling: a single-center experience
Scott O Trerotola1, Melissa Asmar1, Yan Yan1
1Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104.
Journal of Vascular and Interventional Radiology : JVIR
|August 19, 2014
Summary
Adrenal vein sampling (AVS) failures, often due to sample dilution on the left, can still guide treatment. Repeat AVS procedures are frequently successful in diagnosing aldosteronism.
Area of Science:
- Endocrinology
- Interventional Radiology
Background:
- Adrenal vein sampling (AVS) is crucial for diagnosing aldosteronism.
- Identifying and mitigating AVS failure modes is essential for accurate diagnosis and treatment.
Purpose of the Study:
- To analyze failure modes in a high-volume adrenal vein sampling (AVS) practice.
- To identify preventable causes of nondiagnostic AVS procedures.
Main Methods:
- Retrospective analysis of 343 AVS procedures over 10 years.
- Review of nondiagnostic procedures for failure modes and correlation with repeat AVS outcomes.
- Data included selectivity index, lateralization index, and adrenalectomy outcomes.
Main Results:
- 3.5% of primary AVS procedures were nondiagnostic.
- Common failure modes included sample dilution (50%), misidentified vessels (21%), and failure to locate veins (14%).
- Left-sided failures were primarily due to dilution; repeat AVS was diagnostic in 60% of cases.
Conclusions:
- Left-sided AVS failures are predominantly linked to sample dilution.
- Technically nondiagnostic AVS may still provide sufficient data for treatment guidance.
- Repeat AVS procedures demonstrate a high success rate for diagnosis.
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