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Recent Advances in the Clinical Application of Adrenal Vein Sampling

We reviewed clinical research investigating the applications of adrenal vein sampling (AVS). AVS could be applied not only to primary aldosteronism (PA) but also to other endocrine diseases, such as adrenocorticotropic hormone (ACTH) independent Cushing syndrome (AICS) and hyperandrogenemia (HA). Ho...

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Autores principales: Zhong, Shan, Zhang, Tianyue, He, Minzhi, Yu, Hanxiao, Liu, Zhenjie, Li, Zhongyi, Song, Xiaoxiao, Xu, Xiaohong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863662/
https://www.ncbi.nlm.nih.gov/pubmed/35222268
http://dx.doi.org/10.3389/fendo.2022.797021
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author Zhong, Shan
Zhang, Tianyue
He, Minzhi
Yu, Hanxiao
Liu, Zhenjie
Li, Zhongyi
Song, Xiaoxiao
Xu, Xiaohong
author_facet Zhong, Shan
Zhang, Tianyue
He, Minzhi
Yu, Hanxiao
Liu, Zhenjie
Li, Zhongyi
Song, Xiaoxiao
Xu, Xiaohong
author_sort Zhong, Shan
collection PubMed
description We reviewed clinical research investigating the applications of adrenal vein sampling (AVS). AVS could be applied not only to primary aldosteronism (PA) but also to other endocrine diseases, such as adrenocorticotropic hormone (ACTH) independent Cushing syndrome (AICS) and hyperandrogenemia (HA). However, the AVS protocol requires improvements to increase its success rate. Using the computed tomography image fusion, coaxial guidewire technique, and fast intraprocedural cortisol testing (CCF) technique could improve the success rate of catheterization in AVS for PA. ACTH loading could be considered in medical centers with a low selectivity of AVS for PA but is not essential in those with mature AVS technology. The continuous infusion method should be recommended for ACTH stimulation in AVS for PA to reduce adverse events. AVS has not been routinely recommended before management decisions in AICS, but several studies verified that AVS was useful in finding out the source of excess cortisol, especially for distinguishing unilateral from bilateral disease. However, it is necessary to reassess the results of AVS in AICS with the use of reference hormones to fully normalize cortisol levels. In addition, it is essential to determine the optimal model that combines AVS results and mass size to guide the selection of surgical plans, including identifying the dominant gland and presenting the option of staged adrenalectomy, to minimize the impact of bilateral resection. For HA, AVS combined with ovarian intravenous sampling to locate excess androgens could be considered when imaging results are equivocal.
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spelling pubmed-88636622022-02-24 Recent Advances in the Clinical Application of Adrenal Vein Sampling Zhong, Shan Zhang, Tianyue He, Minzhi Yu, Hanxiao Liu, Zhenjie Li, Zhongyi Song, Xiaoxiao Xu, Xiaohong Front Endocrinol (Lausanne) Endocrinology We reviewed clinical research investigating the applications of adrenal vein sampling (AVS). AVS could be applied not only to primary aldosteronism (PA) but also to other endocrine diseases, such as adrenocorticotropic hormone (ACTH) independent Cushing syndrome (AICS) and hyperandrogenemia (HA). However, the AVS protocol requires improvements to increase its success rate. Using the computed tomography image fusion, coaxial guidewire technique, and fast intraprocedural cortisol testing (CCF) technique could improve the success rate of catheterization in AVS for PA. ACTH loading could be considered in medical centers with a low selectivity of AVS for PA but is not essential in those with mature AVS technology. The continuous infusion method should be recommended for ACTH stimulation in AVS for PA to reduce adverse events. AVS has not been routinely recommended before management decisions in AICS, but several studies verified that AVS was useful in finding out the source of excess cortisol, especially for distinguishing unilateral from bilateral disease. However, it is necessary to reassess the results of AVS in AICS with the use of reference hormones to fully normalize cortisol levels. In addition, it is essential to determine the optimal model that combines AVS results and mass size to guide the selection of surgical plans, including identifying the dominant gland and presenting the option of staged adrenalectomy, to minimize the impact of bilateral resection. For HA, AVS combined with ovarian intravenous sampling to locate excess androgens could be considered when imaging results are equivocal. Frontiers Media S.A. 2022-02-09 /pmc/articles/PMC8863662/ /pubmed/35222268 http://dx.doi.org/10.3389/fendo.2022.797021 Text en Copyright © 2022 Zhong, Zhang, He, Yu, Liu, Li, Song and Xu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Zhong, Shan
Zhang, Tianyue
He, Minzhi
Yu, Hanxiao
Liu, Zhenjie
Li, Zhongyi
Song, Xiaoxiao
Xu, Xiaohong
Recent Advances in the Clinical Application of Adrenal Vein Sampling
title Recent Advances in the Clinical Application of Adrenal Vein Sampling
title_full Recent Advances in the Clinical Application of Adrenal Vein Sampling
title_fullStr Recent Advances in the Clinical Application of Adrenal Vein Sampling
title_full_unstemmed Recent Advances in the Clinical Application of Adrenal Vein Sampling
title_short Recent Advances in the Clinical Application of Adrenal Vein Sampling
title_sort recent advances in the clinical application of adrenal vein sampling
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863662/
https://www.ncbi.nlm.nih.gov/pubmed/35222268
http://dx.doi.org/10.3389/fendo.2022.797021
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