Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western India
Introduction: The protocols and criteria used for adrenal venous sampling (AVS) differ across centres. There are no studies from the Indian subcontinent describing AVS-based outcomes in primary aldosteronism (PA). We aim to describe our experience from a single centre. Methods: Retrospective records...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2023;volume=27;issue=1;spage=80;epage=86;aulast=Rathod |
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| author | Krantikumar Rathod Saba S Memon Punit Mahajan Anurag Lila Dhaval Thakkar Hemant Deshmukh Tushar Bandgar |
| author_facet | Krantikumar Rathod Saba S Memon Punit Mahajan Anurag Lila Dhaval Thakkar Hemant Deshmukh Tushar Bandgar |
| author_sort | Krantikumar Rathod |
| collection | DOAJ |
| description | Introduction: The protocols and criteria used for adrenal venous sampling (AVS) differ across centres. There are no studies from the Indian subcontinent describing AVS-based outcomes in primary aldosteronism (PA). We aim to describe our experience from a single centre. Methods: Retrospective records from 2018 to 2020 of patients with confirmed PA who underwent AVS were reviewed. Clinical, imaging, AVS data and outcomes (as per PASO criteria) were recorded. AVS was performed by sequential sampling with cosyntropin stimulation with intraprocedural cortisol and cut-off of selectivity >5 and lateralization >4 by a single radiologist. Results: Fifteen patients with median age of 50 years (41–58) and duration of hypertension of 156 (36–204) months were included. Ten had grade 3 hypertension, 13 had hypokalaemia and 3 had hypokalaemic paralysis. On CT scan, eight patients had bilateral adrenal lesions, four had unilateral adenoma and three patients had normal adrenals. AVS was bilaterally successful in all and showed lateralization of disease in 10 patients and was bilateral in the remaining 5 patients. Overall concordance of CT and AVS was 5/15 (33.3%). Among seven patients who underwent surgery, complete clinical success was seen in two and partial clinical success in the remaining five. Complete biochemical success was seen in two and partial in one. There were no major complications. Conclusions: AVS performed by a single radiologist with defined protocols has a good success rate. AVS has additional value over CT scan in lateralization, especially when CT shows bilateral disease. |
| first_indexed | 2024-03-13T10:37:22Z |
| format | Article |
| id | doaj.art-b8dac454d8fd47559c1d18c9b1697a5f |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-03-13T10:37:22Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-b8dac454d8fd47559c1d18c9b1697a5f2023-05-18T05:47:05ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102023-01-01271808610.4103/ijem.ijem_177_22Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western IndiaKrantikumar RathodSaba S MemonPunit MahajanAnurag LilaDhaval ThakkarHemant DeshmukhTushar BandgarIntroduction: The protocols and criteria used for adrenal venous sampling (AVS) differ across centres. There are no studies from the Indian subcontinent describing AVS-based outcomes in primary aldosteronism (PA). We aim to describe our experience from a single centre. Methods: Retrospective records from 2018 to 2020 of patients with confirmed PA who underwent AVS were reviewed. Clinical, imaging, AVS data and outcomes (as per PASO criteria) were recorded. AVS was performed by sequential sampling with cosyntropin stimulation with intraprocedural cortisol and cut-off of selectivity >5 and lateralization >4 by a single radiologist. Results: Fifteen patients with median age of 50 years (41–58) and duration of hypertension of 156 (36–204) months were included. Ten had grade 3 hypertension, 13 had hypokalaemia and 3 had hypokalaemic paralysis. On CT scan, eight patients had bilateral adrenal lesions, four had unilateral adenoma and three patients had normal adrenals. AVS was bilaterally successful in all and showed lateralization of disease in 10 patients and was bilateral in the remaining 5 patients. Overall concordance of CT and AVS was 5/15 (33.3%). Among seven patients who underwent surgery, complete clinical success was seen in two and partial clinical success in the remaining five. Complete biochemical success was seen in two and partial in one. There were no major complications. Conclusions: AVS performed by a single radiologist with defined protocols has a good success rate. AVS has additional value over CT scan in lateralization, especially when CT shows bilateral disease.http://www.ijem.in/article.asp?issn=2230-8210;year=2023;volume=27;issue=1;spage=80;epage=86;aulast=Rathodadrenal hypertensionadrenal vein samplingprimary aldosteronism |
| spellingShingle | Krantikumar Rathod Saba S Memon Punit Mahajan Anurag Lila Dhaval Thakkar Hemant Deshmukh Tushar Bandgar Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western India Indian Journal of Endocrinology and Metabolism adrenal hypertension adrenal vein sampling primary aldosteronism |
| title | Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western India |
| title_full | Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western India |
| title_fullStr | Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western India |
| title_full_unstemmed | Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western India |
| title_short | Adrenal venous sampling in primary aldosteronism: Single-centre experience from Western India |
| title_sort | adrenal venous sampling in primary aldosteronism single centre experience from western india |
| topic | adrenal hypertension adrenal vein sampling primary aldosteronism |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2023;volume=27;issue=1;spage=80;epage=86;aulast=Rathod |
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