Publicaciones científicas
Adrenal venous sampling in primary aldosteronism: Experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register)
Marta Araujo-Castro 1 2 3 , Miguel Paja Fano 4 5 , Marga González Boillos 6 , Begoña Pla Peris 6 , Eider Pascual-Corrales 7 , Ana María García Cano 8 , Paola Parra Ramírez 9 , Patricia Martín Rojas-Marcos 9 , Jorge Gabriel Ruiz-Sanchez 10 , Almudena Vicente Delgado 11 , Emilia Gómez Hoyos 12 , Rui Ferreira 13 , Iñigo García Sanz 14 , Mònica Recasens Sala 15 , Rebeca Barahona San Millan 15 , María José Picón César 16 17 , Patricia Díaz Guardiola 18 , Juan Jesús García González 19 , Carolina M Perdomo 20 , Laura Manjón Miguélez 21 22 , Rogelio García Centeno 23 , Juan Carlos Percovich 23 , Ángel Rebollo Román 24 , Paola Gracia Gimeno 25 , Cristina Robles Lázaro 26 , Manuel Morales-Ruiz 27 , Felicia A Hanzu 28
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.
CITA DEL ARTÍCULO Endocrine. 2022 Nov;78(2):363-372. doi: 10.1007/s12020-022-03122-8. Epub 2022 Jun 25.
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