Role of adrenal vein sampling in primary aldosteronism: Impact of imaging, localization, and age

Journal of Surgical Oncology
Heather WachtelDouglas L Fraker

Abstract

The role of adrenal vein sampling (AVS) has been debated, with some authorities advocating selective use in younger patients (≤40 years), and those localized by preoperative imaging. We examined our experience to determine the impact of AVS in patients who routinely underwent AVS with a high success rate. A retrospective cohort study was performed using a prospectively maintained database of patients referred for evaluation of PA (1997-2013). Patients were classified as localized (L) if a unilateral mass was identified on imaging, and non-localized (NL) otherwise. Of 367 patients, 94% (n = 345) underwent successful AVS. Seventy-two percent (n = 265) were L; AVS was lateralizing 58% (n = 214). AVS changed management in 43% of patients (n = 158). In patients ≤40 years, AVS changed management in 30% (n = 15). In patients ≤40 years with a ≥1 cm adrenal mass, 12% (n = 3) would have undergone unnecessary surgery based on imaging results alone; in patients >40 years with a ≥1 cm adrenal mass, 3% (n = 5) would have undergone wrong-side surgery, and 30% (n = 50) would have undergone unnecessary surgery based on imaging. AVS changed management in a significant minority of patients regardless of age and imaging findings. AVS should be rou...Continue Reading

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Citations

Aug 14, 2018·The Journal of Clinical Endocrinology and Metabolism·Masao TakedaUNKNOWN JPAS Study Group
Nov 14, 2019·Journal of the American Medical Informatics Association : JAMIA·Lingjiao ZhangJinbo Chen
May 1, 2019·Equine Veterinary Journal·D BorkentP M Dixon
Nov 5, 2020·JAMA Surgery·Gerard M DohertyQuan-Yang Duh
Aug 23, 2020·The Journal of Surgical Research·Alyssa YeungAmanda M Laird

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