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J Vasc Interv Radiol. 2007 Sep;18(9):1102-5.

Adjunctive use of C-arm CT may eliminate technical failure in adrenal vein sampling.

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1
Division of Vascular and Interventional Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, Blalock 545, Baltimore, Maryland 21287, USA. cgeorgi@jhmi.edu

Abstract

PURPOSE:

To examine whether the use of C-arm computed tomography (CT) during adrenal vein sampling improves the technical success rate of the procedure.

MATERIALS AND METHODS:

Nine consecutive patients with suspected primary hyperaldosteronism underwent standard adrenal vein sampling that included cortisol stimulation. The procedure was augmented with multiplanar C-arm CT images reconstructed from data acquired during a 180 degrees C-arm rotation. Whenever C-arm CT images showed the sampling catheter to be in the wrong position, the catheter was repositioned. Cortisol response was correlated to C-arm CT findings.

RESULTS:

All patients had successful and diagnostic adrenal vein sampling. C-arm CT showed sampling catheter malposition in two patients (22%). Repeat C-arm CT after repositioning showed proper catheter location. Cortisol stimulation results and C-arm CT findings were concordant in 100% of cases.

CONCLUSIONS:

C-arm CT is reliable in confirming the location of sampling catheters during adrenal vein sampling. If the 100% concordance between cortisol stimulation and C-arm CT findings is found in larger groups, the technical success rate may approach 100%. Cortisol stimulation may become obsolete and repeat procedures unnecessary, with significant time and cost savings.

Comment in

PMID:
17804771
DOI:
10.1016/j.jvir.2007.06.018
[Indexed for MEDLINE]
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