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Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes

Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is un...

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Autores principales: Deipolyi, Amy R., Bailin, Alexander, Wicky, Stephan, Alansari, Shehab, Oklu, Rahmi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665593/
https://www.ncbi.nlm.nih.gov/pubmed/26854152
http://dx.doi.org/10.3390/diagnostics5020254
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author Deipolyi, Amy R.
Bailin, Alexander
Wicky, Stephan
Alansari, Shehab
Oklu, Rahmi
author_facet Deipolyi, Amy R.
Bailin, Alexander
Wicky, Stephan
Alansari, Shehab
Oklu, Rahmi
author_sort Deipolyi, Amy R.
collection PubMed
description Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management.
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spelling pubmed-46655932016-01-27 Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes Deipolyi, Amy R. Bailin, Alexander Wicky, Stephan Alansari, Shehab Oklu, Rahmi Diagnostics (Basel) Article Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management. MDPI 2015-06-19 /pmc/articles/PMC4665593/ /pubmed/26854152 http://dx.doi.org/10.3390/diagnostics5020254 Text en © 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Deipolyi, Amy R.
Bailin, Alexander
Wicky, Stephan
Alansari, Shehab
Oklu, Rahmi
Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes
title Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes
title_full Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes
title_fullStr Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes
title_full_unstemmed Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes
title_short Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes
title_sort adrenal vein sampling for conn’s syndrome: diagnosis and clinical outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665593/
https://www.ncbi.nlm.nih.gov/pubmed/26854152
http://dx.doi.org/10.3390/diagnostics5020254
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