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Advantages of Intraprocedural Unenhanced CT During Adrenal Venous Sampling to Confirm Accurate Catheterization of the Right Adrenal Vein

  • Koji Maruyama
  • Keitaro Sofue
  • Takuya Okada
  • Yutaka Koide
  • Eisuke Ueshima
  • Genzo Iguchi
  • Ryuichiro Tani
  • Tomoyuki Gentsu
  • Hiroki Horinouchi
  • Koji Sasaki
  • Masato Yamaguchi
  • Koji Sugimoto
  • Takamichi Murakami
Clinical Investigation Venous Interventions
  • 20 Downloads
Part of the following topical collections:
  1. Venous Interventions

Abstract

Purpose

To evaluate the advantages of intraprocedural CT during adrenal venous sampling (AVS) to confirm accurate catheterization of the right adrenal vein (RAV).

Materials and Methods

This single-institution study included 106 patients (mean age 52.4 years; range 28–74 years) with primary aldosteronism who performed contrast-enhanced CT (CECT) before AVS following AVS between January 2011 and March 2018. After catheterization of the RAV under fluoroscopic guidance, unenhanced CT images were obtained to confirm catheter position on unified CT angiography system. Catheter repositioning was performed when the catheter was inaccurately positioned. Venography findings were classified into two groups: (1) presumably cannulated in the RAV (presumed RAV group) and (2) obscured visualization of the RAV because of collateral vessels (obscured RAV group). Success rates of AVS were compared using Fisher’s exact test.

Results

The overall success of AVS was achieved in 104 patients (98.1%). Catheter was deviated into the IVC during intraprocedural CT in four patients. Fourteen patients (14.0%) required catheter repositioning by intraprocedural CT images, and accurate catheterization in the RAV was eventually accomplished. The success rate of AVS was significantly higher in the presumed RAV group (90.1% [73/81]) than that in the obscured RAV group (68.4% [13/19]) (p = 0.024). If intraprocedural CT was not acquired during AVS, the success rate of AVS would have been significantly lower (84.9% [90/106]) compared with that use of intraprocedural CT (98.1% [104/106]) (p < 0.001).

Conclusions

Intraprocedural unenhanced CT by referring to the preprocedural CECT before AVS enables the confirmation of accurate catheterization of the RAV.

Level of Evidence

Level 4, case series.

Keywords

Aldosteronism Adrenal venous sampling Computed tomography Adrenal vein Catheter 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

This retrospective study design was approved by our institutional review board. For this type of study formal consent is not required.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Koji Maruyama
    • 1
  • Keitaro Sofue
    • 1
  • Takuya Okada
    • 1
  • Yutaka Koide
    • 1
  • Eisuke Ueshima
    • 1
  • Genzo Iguchi
    • 2
  • Ryuichiro Tani
    • 1
  • Tomoyuki Gentsu
    • 1
  • Hiroki Horinouchi
    • 1
  • Koji Sasaki
    • 1
  • Masato Yamaguchi
    • 1
  • Koji Sugimoto
    • 1
  • Takamichi Murakami
    • 1
  1. 1.Department of RadiologyKobe University Graduate School of MedicineKobeJapan
  2. 2.Division of Diabetes and EndocrinologyKobe University HospitalKobeJapan

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