Enhanced CT-guided adrenal venous sampling versus traditional X-ray-guided adrenal venous sampling in patients with primary aldosteronism

To compare the accuracy, safety, operation time, and radiation dose of enhanced computed tomography (CT)-guided adrenal vein sampling (AVS) versus traditional X-ray-guided AVS in patients with primary aldosteronism. A total of 97 patients with primary aldosteronism were randomly assigned to either the enhanced CT-guided group (n = 48) or the traditional X-ray-guided group (n = 49). Baseline characteristics were compared between the 2 groups. The primary outcome was the accuracy of AVS, assessed by aldosterone-to-cortisol ratio. Secondary outcomes included safety measures (intraoperative and postoperative complication rates, procedure termination rates, blood pressure, and heart rate changes), operation time, and radiation dose. The CT-guided group demonstrated significantly higher aldosterone-to-cortisol ratios, indicating improved accuracy in AVS (P < .001). The CT-guided group also showed significantly lower intraoperative blood pressure change and intraoperative heart rate change compared to the X-ray-guided group (P < .05). In addition, the CT-guided group had significantly shorter operation times (P < .001) and lower radiation exposure (P < .001). The enhanced CT-guided AVS demonstrated significantly better accuracy, safety, and efficiency compared to traditional X-ray-guided AVS in patients with primary aldosteronism. The enhanced CT-guided approach also resulted in lower radiation exposure for patients, making it a favorable option in the diagnosis and treatment of primary aldosteronism.