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Adrenal vein sampling inconsistently conducted at health care centers
Rossi GP. J Clin Endocrinol Metab. 2012;doi:10.1210/jc.2011-2830
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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.
Disclosure: The researchers report no relevant financial disclosures.