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25-06-2022 | Adrenalectomy | Original Article

Adrenal venous sampling in primary aldosteronism: Experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register)

Authors: Marta Araujo-Castro, Miguel Paja Fano, Marga González Boillos, Begoña Pla Peris, Eider Pascual-Corrales, Ana María García Cano, Paola Parra Ramírez, Patricia Martín Rojas-Marcos, Jorge Gabriel Ruiz-Sanchez, Almudena Vicente Delgado, Emilia Gómez Hoyos, Rui Ferreira, Iñigo García Sanz, Mònica Recasens Sala, Rebeca Barahona San Millan, María José Picón César, Patricia Díaz Guardiola, Juan Jesús García González, Carolina M. Perdomo, Laura Manjón Miguélez, Rogelio García Centeno, Juan Carlos Percovich, Ángel Rebollo Román, Paola Gracia Gimeno, Cristina Robles Lázaro, Manuel Morales-Ruiz, Felicia A. Hanzu

Published in: Endocrine | Issue 2/2022

Abstract

Objective

The aim of this study was to evaluate the rate of adrenal venous sampling (AVS) performance in patients with primary aldosteronism (PA), the main reasons for its non-performance, and the success and complications rate of this procedure in Spain. Moreover, the concordance between CT/MRI and AVS for PA subtyping was evaluated.

Methods

A retrospective multicenter study of PA patient follow-up in 20 Spanish tertiary hospitals between 2018–2021 was performed (SPAIN-ALDO Register).

Results

Of the 440 patients with PA included in the study, 153 underwent AVS (34.8%). The main reasons for not performing AVS were: patient rejection to the procedure, low catheterization rate in the center and unilateral disease based on CT/MRI. The overall success rate was 44.4% (the left adrenal vein was properly canulated in 77.8% and the right adrenal vein in 48.4%). Only 3 patients experienced minor complications. In the 45 patients with unilateral disease according to AVS, CT/MRI indicated bilateral disease or normal adrenal glands in 17. In the 23 patients with bilateral disease, CT/MRI indicated unilateral disease in 14. However, no significant differences were observed in biochemical response (P = 0.051) and hypertension resolution (P = 0.150) between patients who underwent surgery based on CT/MRI results and those who underwent surgery based on AVS results.

Conclusion

In our setting, AVS is still an underused technique in patients with PA. The low experience and success rate in AVS partially justify these results. More training for providers and patients needs to be done to include appropriate well performed AVS in the diagnosis algorithm of PA.

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Title: Adrenal venous sampling in primary aldosteronism: Experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register)
Authors: Marta Araujo-Castro
Miguel Paja Fano
Marga González Boillos
Begoña Pla Peris
Eider Pascual-Corrales
Ana María García Cano
Paola Parra Ramírez
Patricia Martín Rojas-Marcos
Jorge Gabriel Ruiz-Sanchez
Almudena Vicente Delgado
Emilia Gómez Hoyos
Rui Ferreira
Iñigo García Sanz
Mònica Recasens Sala
Rebeca Barahona San Millan
María José Picón César
Patricia Díaz Guardiola
Juan Jesús García González
Carolina M. Perdomo
Laura Manjón Miguélez
Rogelio García Centeno
Juan Carlos Percovich
Ángel Rebollo Román
Paola Gracia Gimeno
Cristina Robles Lázaro
Manuel Morales-Ruiz
Felicia A. Hanzu
Publication date: 25-06-2022
Publisher: Springer US
Keywords: Adrenalectomy
Hypertension
Adrenalectomy
Hypertension
Published in: Endocrine / Issue 2/2022
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-022-03122-8

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