Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures
PURPOSE:Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging betw...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2018-03-01
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| Series: | Diagnostic and Interventional Radiology |
| Online Access: |
http://www.dirjournal.org/archives/archive-detail/article-preview/adrenal-venous-sampling-the-learning-curve-of-a-si/55142
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| _version_ | 1797691214011564032 |
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| author | Hugo Jakobsson Katerina Farmaki Augustinas Sakinis Olof Ehn Gudmundur Johannsson Oskar Ragnarsson |
| author_facet | Hugo Jakobsson Katerina Farmaki Augustinas Sakinis Olof Ehn Gudmundur Johannsson Oskar Ragnarsson |
| author_sort | Hugo Jakobsson |
| collection | DOAJ |
| description | PURPOSE:Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging between 30% and 96%. The aim of this study was to investigate the success rate of AVS over time, performed by a single interventionalist.METHODS:This was a retrospective study based on consecutive AVS procedures performed by a single operator between September 2005 and June 2016. Data on serum concentrations of aldosterone and cortisol from right and left adrenal vein, inferior vena cava, and peripheral vein were collected and selectivity index (SI) calculated. Successful AVS was defined as SI >5.RESULTS:In total, 282 AVS procedures were performed on 269 patients, 168 men (62%) and 101 women (38%), with a mean age of 55±11 years (range, 26–78 years). Out of 282 AVS procedures, 259 were successful, giving an overall success rate of 92%. The most common reason for failure was inability to localize the right adrenal vein (n=16; 76%). The success rates were 63%, 82%, and 94% during the first, second, and third years, respectively. During the last 8 years the success rate was 95%, and on average 27 procedures were performed annually.CONCLUSION:Satisfactory AVS success rate was achieved after approximately 36 procedures and satisfactory success rate was maintained by performing approximately 27 procedures annually. AVS should be limited to few operators that perform sufficiently large number of procedures to achieve, and maintain, satisfactory AVS success rate. |
| first_indexed | 2024-03-12T02:11:06Z |
| format | Article |
| id | doaj.art-6a23ad71591a4796ac617c2b0837c154 |
| institution | Directory Open Access Journal |
| issn | 1305-3825 1305-3612 |
| language | English |
| last_indexed | 2024-03-12T02:11:06Z |
| publishDate | 2018-03-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Diagnostic and Interventional Radiology |
| spelling | doaj.art-6a23ad71591a4796ac617c2b0837c1542023-09-06T13:22:14ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122018-03-01242899310.5152/dir.2018.1739713049054Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive proceduresHugo Jakobsson0Katerina Farmaki1Augustinas Sakinis2Olof Ehn3Gudmundur Johannsson4Oskar Ragnarsson5 Institution of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden. Institution of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden. Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden (A.S.). Institution of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden. Institution of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden. Institution of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden. PURPOSE:Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging between 30% and 96%. The aim of this study was to investigate the success rate of AVS over time, performed by a single interventionalist.METHODS:This was a retrospective study based on consecutive AVS procedures performed by a single operator between September 2005 and June 2016. Data on serum concentrations of aldosterone and cortisol from right and left adrenal vein, inferior vena cava, and peripheral vein were collected and selectivity index (SI) calculated. Successful AVS was defined as SI >5.RESULTS:In total, 282 AVS procedures were performed on 269 patients, 168 men (62%) and 101 women (38%), with a mean age of 55±11 years (range, 26–78 years). Out of 282 AVS procedures, 259 were successful, giving an overall success rate of 92%. The most common reason for failure was inability to localize the right adrenal vein (n=16; 76%). The success rates were 63%, 82%, and 94% during the first, second, and third years, respectively. During the last 8 years the success rate was 95%, and on average 27 procedures were performed annually.CONCLUSION:Satisfactory AVS success rate was achieved after approximately 36 procedures and satisfactory success rate was maintained by performing approximately 27 procedures annually. AVS should be limited to few operators that perform sufficiently large number of procedures to achieve, and maintain, satisfactory AVS success rate. http://www.dirjournal.org/archives/archive-detail/article-preview/adrenal-venous-sampling-the-learning-curve-of-a-si/55142 |
| spellingShingle | Hugo Jakobsson Katerina Farmaki Augustinas Sakinis Olof Ehn Gudmundur Johannsson Oskar Ragnarsson Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures Diagnostic and Interventional Radiology |
| title | Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures |
| title_full | Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures |
| title_fullStr | Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures |
| title_full_unstemmed | Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures |
| title_short | Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures |
| title_sort | adrenal venous sampling the learning curve of a single interventionalist with 282 consecutive procedures |
| url |
http://www.dirjournal.org/archives/archive-detail/article-preview/adrenal-venous-sampling-the-learning-curve-of-a-si/55142
|
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