Endocrine Abstracts

Introduction: Adrenal vein sampling (AVS) is the gold standard test to distinguish between unilateral adenoma and bilateral hyperplasia in primary hyperaldosteronism. This is a technical complicated procedure with a variable success rate. Our aim was to report our 10-year-success rate and results as regards to this procedure.

Material and Methods: Retrospective observational study including data from patients undergoing AVS between 2009 and 2019.

Results: Data from 15 patients, 7 women and 8 men (48.1 ± 5.5 years old, BMI 33.7 ± 5.23 kg/m², blood pressure 157.3 ± 13.1/94 ± 10.2 mmHg) were analyzed. Previous diagnostic imaging tests (Computerized Tomography/Magnetic Resonance Imaging) showed 5 unilateral adrenal adenomas, 2 bilateral adrenal adenomas and 8 images were normal. The success rate of AVS was 60% (9/15). AVS showed lateralization in 6 cases (left lateralization in 5 of them) Imaging test-AVS concordance was 67%. 6 patients underwent adrenalectomy, with anatomo-phatological result of cortical adenoma in 4 of them and cortical hyperplasia in 2. Blood pressure after surgery: 137.5 ± 5.2/ 85 ± 4.47 mmHg. Adrenal veins were not properly catheterized in 6 cases (5 of them due to inappropriate catheterization of right adrenal vein and 1 due to inappropriate catheterization of both right and left adrenal veins). Complications reported consisted on a unique event of adrenal hemorrhage.

Conclusion: AVS is considered to be the gold standard test to determine the subtype of primary hyperaldosteronism. Success rate of AVS is highly variable. In low-volume centres, as ours, percentage ranges between 40 and 70%, therefore our 60% success rate could be considered acceptable.