Comparison of three approaches for adrenal venous sampling in patients with primary aldosteronism.

IF 5.4 2区医学 Q1 Medicine

Journal of Endocrinological Investigation Pub Date : 2025-03-15 DOI:10.1007/s40618-025-02551-2

Hui Dong, Yujie Zuo, Hongwu Li, Kaiwen Jiang, Yubao Zou, Wentao Ma, Wenjun Ma, Xiongjing Jiang

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引用次数: 0

Abstract

Purpose: To compare the feasibility and safety of three approaches for bilateral adrenal venous sampling (AVS) and their influence on the outcomes of adrenalectomy for dominant lateral primary aldosteronism (PA).

Methods: 182 PA patients who underwent AVS at Fuwai Hospital between January 2022 and March 2024 were enrolled. According to the puncture access, patients were divided into three groups: simultaneous AVS via antecubital approach group (Group A, N = 48), simultaneous AVS via femoral approach group (Group B, N = 44) and sequential AVS via antecubital approach group (Group C, N = 90). The baseline data, procedure parameters, success rates, complication rates and follow-up data were analyzed.

Results: The baseline characteristics did not differ significantly among three groups (all P > 0.05). The procedure time (18.9 ± 7.4 min vs. 25.2 ± 7.5 min; P < 0.001) and fluoroscopy time (7.1 ± 3.8 min vs. 10.8 ± 6.2 min; P < 0.001) were shorter in Group A than in Group C. However, there was no significant difference between Group A and B (all P > 0.05). The bilateral sampling success rates in Groups A, B and C were 93.8%, 93.2% and 91.1%, respectively, which were not significantly different (P = 0.936). One (0.5%) adrenal haematoma was recorded in Group B. The complete clinical success rate (P = 0.894) and complete biochemical success rate (P = 0.954) were not significantly different in patients with dominant lateralization who underwent adrenalectomy.

Conclusion: This study revealed that three approaches for AVS are safe and feasible, with similar outcomes after adrenalectomy. Simultaneous AVS via antecubital approach might be a better choice considering its shorter procedure and fluoroscopy time and comfort.

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原发性醛固酮增多症患者肾上腺静脉取样三种方法的比较。

目的：比较双侧肾上腺静脉取样（AVS）三种入路的可行性和安全性，以及它们对显性外侧原发性醛固酮增多症（PA）肾上腺切除术结果的影响。方法：选取2022年1月至2024年3月阜外医院行AVS的PA患者182例。根据穿刺途径将患者分为三组：经前路同时AVS组（A组，48例）、经股路同时AVS组（B组，44例）和经前路序贯AVS组（C组，90例）。分析基线数据、手术参数、成功率、并发症发生率及随访数据。结果：三组患者基线特征差异无统计学意义（P < 0.05）。手术时间(18.9±7.4 min vs. 25.2±7.5 min；P 0.05)。A、B、C组双侧取样成功率分别为93.8%、93.2%、91.1%，差异无统计学意义（P = 0.936）。b组肾上腺血肿1例（0.5%），临床完全成功率（P = 0.894）和生化完全成功率（P = 0.954）与优势侧化行肾上腺切除术的患者差异无统计学意义。结论：本研究显示三种入路治疗AVS是安全可行的，且肾上腺切除术后效果相似。考虑到手术时间短，透视时间短，舒适度好，同时经肛前入路AVS可能是更好的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Endocrinological Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

8.10

自引率

7.40%

发文量

242

期刊介绍： The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.