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Title: Adrenal venous sampling – A practical approach
e-poster Number: EPOS 6
Category: e Poster
Author Name: Dr. Neeshnat N. Gabhane
Institute:
Co-Author Name:
Abstract :
Aim :-
Approach to primary aldosteronism (PA) secondary to suspicious adrenal adenoma and tips and tricks for adrenal vein sampling (AVS)
Objectives :-
To evaluate the procedural approaching steps involved in AVS.
To determine the optimal approach for AVS in PA by analyzing a case with a suspicious single left adrenal adenoma.
Method :-
A 67-year-old female with PA underwent AVS under basal conditions and during cosyntropin stimulation. Superselective sampling was performed from different adrenal vein branches. Hormonal assays were conducted to determine aldosterone levels and lateralization.
Result :--
AVS involves cannulating the adrenal veins and collecting blood samples for analysis of aldosterone and cortisol levels. Cosyntropin stimulation used to enhance aldosterone secretion.
AVS has a high diagnostic accuracy in identifying unilateral aldosterone production, with reported sensitivity and specificity rates ranging from 80% to 95%
The interpretation of AVS results involves calculating the selectivity index, lateralization index, and contralateral suppression index. These indices help determine the adequacy of sampling and the lateralization of aldosterone production.
Conclusion :--
AVS is a valuable diagnostic tool for primary aldosteronism.
It demonstrates superior efficacy in lateralizing aldosterone production compared to CT scan.
Superselective catheterization and cosyntropin stimulation can be utilized strategically, but careful interpretation is crucial.
It can accurately determine the lateralization of aldosterone production, guiding appropriate treatment decisions.
Surgical management guided by AVS results can lead to favorable clinical and biochemical outcomes in patients with PA.
