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Updated: Jun 5, 2025
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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
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Using Point of Care Rapid Cortisol Measurement During Adrenal Venous Sampling in Primary Hyperaldosteronism
Hadas Rabani1, Mohammad Sheikh-Ahmad1,2, Robert Sachner3
1Endocrinology Unit, Bnai Zion Medical Center, 47 Eliyahu Golomb Boulevard, Haifa 31048, Israel.
Diagnostics (Basel, Switzerland)
|December 17, 2024
Summary
Point-of-care rapid cortisol (RC) testing during adrenal venous sampling (AVS) improves success rates and reduces costs. This method allows real-time assessment of catheter placement, minimizing the need for repeat procedures and saving an average of $1288 per patient.
Area of Science:
- Endocrinology
- Interventional Radiology
- Clinical Chemistry
Background:
- Primary hyperaldosteronism diagnosis relies on adrenal venous sampling (AVS).
- Traditional AVS can have variable success rates and may require repeat procedures.
- Point-of-care testing offers potential for real-time diagnostic feedback.
Purpose of the Study:
- To evaluate the success rates of AVS with point-of-care rapid cortisol (RC) testing.
- To assess the cost-effectiveness of implementing RC testing in AVS procedures.
- To compare AVS outcomes before and after the introduction of RC testing.
Main Methods:
- Retrospective review of 55 AVS procedures (January 2016 - June 2024).
- Comparison between a historical cohort (n=36) and a cohort using RC testing (n=19).
- RC testing utilized a europium nanoparticle-based fluoro-immunoassay for rapid cortisol measurement.
Main Results:
- Right adrenal vein sampling success rates were 79% with RC testing versus 67% historically.
- In 31.5% of RC cases, low selectivity index values identified unsuccessful cannulation promptly.
- RC testing led to an average cost saving of $1288 per patient by reducing repeat AVS.
Conclusions:
- Rapid cortisol measurement during AVS is cost-effective and improves procedural success.
- Real-time RC analysis enables immediate decisions on catheter placement and sampling needs.
- This approach reduces the necessity for repeat AVS sessions, optimizing patient care and resource utilization.
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