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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 1/2018

01-01-2018 | Clinical Investigation

Eleven-Year Retrospective Report of Super-Selective Venous Sampling for the Evaluation of Recurrent or Persistent Hyperparathyroidism in 32 Patients

Authors: Peiman Habibollahi, Benjamin Shin, Sara P. Shamchi, Heather Wachtel, Douglas L. Fraker, Scott O. Trerotola

Published in: CardioVascular and Interventional Radiology | Issue 1/2018

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Abstract

Purpose

Parathyroid venous sampling (PAVS) is usually reserved for patients with persistent or recurrent hyperparathyroidism after parathyroidectomy with inconclusive noninvasive imaging studies. A retrospective study was performed to evaluate the diagnostic efficacy of super-selective PAVS (SSVS) in patients needing revision neck surgery with inconclusive imaging.

Materials and Methods

Patients undergoing PAVS between 2005 and 2016 due to persistent or recurrent hyperparathyroidism following surgery were reviewed. PAVS was performed in all patients using super-selective technique. Single-value measurements within central neck veins performed as part of super-selective PAVS were used to simulate selective venous sampling (SVS) and allow for comparison to data, which might be obtained in a non-super-selective approach.

Results

32 patients (mean age 51 ± 15 years; 8 men and 24 women) met inclusion and exclusion criteria. The sensitivity and positive predictive value (PPV) of SSVS for localizing the source of elevated PTH to a limited area in the neck or chest was 96 and 84%, respectively. Simulated SVS, on the other hand, had a sensitivity of 28% and a PPV of 89% based on the predefined gold standard. SSVS had a significantly higher sensitivity compared to simulated SVS (p < 0.001).

Conclusion

SSVS is highly effective in localizing the source of hyperparathyroidism in patients undergoing revision surgery for hyperparathyroidism in whom noninvasive imaging studies are inconclusive. SSVS data had also markedly higher sensitivity for localizing disease in these patients compared to simulated SVS.
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Metadata
Title
Eleven-Year Retrospective Report of Super-Selective Venous Sampling for the Evaluation of Recurrent or Persistent Hyperparathyroidism in 32 Patients
Authors
Peiman Habibollahi
Benjamin Shin
Sara P. Shamchi
Heather Wachtel
Douglas L. Fraker
Scott O. Trerotola
Publication date
01-01-2018
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 1/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1757-3

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