Endocrine Abstracts

Background: Although adrenal vein sampling (AVS) is a technically demanding procedure, it is still considered the gold standard for subtyping primary aldosteronism (PA). The aim of the study was to analyze the success rate of AVS in patients with PA.

Methods: In all patients AVS was performed sequentially during continuous stimulation with adrenocorticotrophic hormone by one interventional radiologist. Adrenal vein cannulation was considered successful if the selectivity ratio was ≥5:1.

Results: Over the 7-year period, 179 procedures were performed in 166 patients (101 men; age 44–60, median 52 years). In the first two years (2016–2017) 30 AVS procedures were performed (group 1) with the success rate of 60% (18/30) whereas in the period from 2018 to 2020 (group 2) and from 2021 to May 2023 (group 3), the success rate of AVS procedures was 79% (57/72 and 61/77), (P=0.019, χ2=21.294). Out of 43 unsuccessful AVS, cannulation of the right and left adrenal veins failed in 31 and 7 cases, respectively, whereas in five patients catheterization failed on both sides. In 13 patients, AVS was repeated after an unsuccessful first procedure, and the success rate of the second AVS was 85% (group 1 50%; group 2 87%; group 3 100%).

Conclusion: The AVS success rate has increased over time from an initial 60% to 79% at the end of the observed period. In selected cases, repeated AVS might be justified after an unsuccessful first procedure.