There is a need for more consistent guidelines on adrenal
vein sampling in patients who seek surgical care of primary aldosteronism,
according to study results.
“Despite carrying a minimal risk of adrenal vein rupture and
at variance with the guidelines, [adrenal vein sampling] is not used
systematically at major referral centers worldwide,” the researchers said. “These
findings represent an argument for defining guidelines for this clinically
important but technically demanding procedure.”
Researchers conducted the Adrenal Vein Sampling
International Study (AVIS) to determine the complication rate of adrenal vein
sampling and to evaluate the ways in which it is performed and interpreted at health
care centers in Asia, Australia, North America and Europe. AVIS is an
observational, retrospective, multicenter study conducted at major referral
centers for endocrine hypertension worldwide.
Twenty of 24 eligible centers participated and provided
information on 2,604 adrenal vein sampling studies during a 6-year period. The
percentage of primary aldosteronism patients who underwent adrenal vein
sampling was 77%.
Thirteen of the centers used sequential catheterization, and
seven used bilaterally simultaneous catheterization; cosyntropin stimulation
was used in 11 centers. The overall rate of adrenal vein rupture was 0.61%.
The Endocrine Society Guidelines recommend the use of adrenal
vein sampling in patients with primary aldosteronism. Adrenal vein sampling has
been known to be invasive, technically challenging, difficult to interpret and risky,
according to the researchers.
researchers report no relevant financial disclosures.