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Updated: Aug 9, 2025
06:08
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
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An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult
Akira Yamamoto1, Takeshi Fukunaga1, Mitsuru Takeuchi2
1Department of Radiology, Kawasaki Medical School, Kurashiki 701-0192, Japan.
Diagnostics (Basel, Switzerland)
|February 25, 2023
Summary
Sampling blood from the inferior vena cava (IVC) near the right adrenal vein (rt.AdV) offers a simpler alternative when direct rt.AdV catheterization is challenging. This modified approach aids in diagnosing primary aldosteronism subtypes.
Area of Science:
- Endocrinology
- Interventional Radiology
- Medical Diagnostics
Background:
- Adrenal vein sampling (AVS) is crucial for diagnosing primary aldosteronism (PA).
- Catheterization of the right adrenal vein (rt.AdV) for AVS can be technically difficult.
- Alternative methods for rt.AdV sampling are needed to improve diagnostic yield.
Purpose of the Study:
- To evaluate the utility of blood sampling from the inferior vena cava (IVC) as a substitute for rt.AdV sampling.
- To compare the diagnostic performance of a modified lateralized index (LI) using IVC samples with the conventional LI.
- To assess the feasibility of using IVC sampling as an ancillary method for AVS.
Main Methods:
- Retrospective analysis of 44 PA patients undergoing AVS with ACTH stimulation.
- Blood samples collected from the IVC near the rt.AdV (S-rt.AdV) alongside direct rt.AdV samples.
- Calculation and comparison of conventional LI and modified LI using S-rt.AdV data.
Main Results:
- The modified LI effectively differentiated between idiopathic hyperaldosteronism (IHA), right-sided APA (rt.APA), and left-sided APA (lt.APA).
- Modified LI values for rt.APA (0.4 ± 0.4) were significantly lower than IHA (1.4 ± 0.7) and lt.APA (3.5 ± 2.0).
- High likelihood ratios were observed for diagnosing rt.APA (27.0) and lt.APA (18.6) using the modified LI.
Conclusions:
- Inferior vena cava sampling near the rt.AdV provides a valuable ancillary method for AVS when direct rt.AdV catheterization is difficult.
- The modified LI using IVC samples is a simple and effective tool for lateralizing aldosterone hypersecretion.
- This technique can potentially improve the success rate and diagnostic accuracy of AVS in PA.
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