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Adrenal Vein Sampling: How We Do It

dc.contributor.authorResende Neves, T
dc.contributor.authorProença Caetano, A
dc.contributor.authorManique, I
dc.contributor.authorAmaral, S
dc.contributor.authorGodinho, C
dc.contributor.authorBilhim, T
dc.contributor.authorCoimbra, E
dc.date.accessioned2024-08-13T08:39:13Z
dc.date.available2024-08-13T08:39:13Z
dc.date.issued2023
dc.description.abstractPrimary aldosteronism is the most common cause of secondary hypertension. When unilateral disease is present, patients can be treated curatively by adrenalectomy. Adrenal vein sampling (AVS) is considered essential for discrimination between unilateral versus bilateral disease. Knowledge of normal and variant anatomy of the adrenal veins is important to avoid misleading results and increase technical success. The main reason for technical failure of AVS is the inability to catheterize the right adrenal vein. Pre-procedural CT imaging can help identify the venous anatomy of the adrenals. To validate the technical success of AVS, the catheterization index is calculated comparing the cortisol levels in each adrenal gland with those of the inferior vena cava. To assess the laterality index, the aldosterone levels are compared between both adrenals. We generally use a femoral access and a 4Fr Berenstein catheter for the left adrenal vein and a 5Fr Cobra, Simmons or Micahelson for the right adrenal vein. Some centers adopt an intravenous perfusion of a synthetic peptide of the adrenocorticotropic hormone immediately prior to the procedure to stimulate the adrenal glands. AVS is a safe and feasible procedure, with low risk of failure. Due to the technical difficulties of execution, especially right adrenal vein cannulation, AVS has low usage among hospital centers. The learning curve is estimated to be around 20 to 30 procedures, with a maintenance of about 15 annual procedures to achieve satisfactory results.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationActa Radiol Port. 2023; 35 (1):19-23pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4976
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Radiologia e Medicina Nuclearpt_PT
dc.subjectAdrenal vein samplingpt_PT
dc.subjectInterventional radiologypt_PT
dc.subjectCatheterization.pt_PT
dc.subjectHCC IMApt_PT
dc.titleAdrenal Vein Sampling: How We Do Itpt_PT
dc.title.alternativeDoseamento Hormonal das Veias Supra-Renais: Como Fazemospt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage23pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage19pt_PT
oaire.citation.volume35pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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