Application value of adrenal venous sampling in the surgical treatment of primary aldosteronism

Qiao,Lin; Peng,Jing; Hao,Xiaodong; Wang,Chenghui; Xie,Mingliang; Ding,Hao

doi:10.3892/etm.2024.12656

Application value of adrenal venous sampling in the surgical treatment of primary aldosteronism

Authors:
- Lin Qiao
- Jing Peng
- Xiaodong Hao
- Chenghui Wang
- Mingliang Xie
- Hao Ding
View Affiliations

Affiliations: Department of Endocrinology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China, Department of Urology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China, Department of Andrology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China, Department of Urology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
Published online on: July 16, 2024 https://doi.org/10.3892/etm.2024.12656
Article Number: 367
Copyright: © Qiao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The diagnosis of primary aldosteronism (PA) is critical for determining treatment strategies. The aim of the present study was to investigate the clinical value of preoperative adrenal venous sampling (AVS) for determining the benefit of PA surgery. Patients diagnosed with PA at Liaocheng People's Hospital (Liaocheng, China) between January 2015 and December 2020 were selected and divided into two groups: Group A underwent adrenal computed tomography (CT) only, whereas Group B underwent adrenal CT and successful AVS. Subsequently, the improvement rate of adrenal CT and adrenal CT + AVS in the treatment of PA was compared. A total of 164 patients were included, with an average age of 46.69±13.64 years. There were 62 patients in Group A and 102 in Group B. Among the patients diagnosed with unilateral lesions on adrenal CT scan, 82.61% of patients in group A and 87.72% in group B showed improvement; however, the difference was not significant (χ2=0.534, P=0.465). Among the patients diagnosed with bilateral lesions on adrenal CT images, 62.50% of patients in Group A and 91.11% of patients in Group B showed improvement (P=0.019). In conclusion, unilateral adrenal lesions detected by CT did not benefit significantly from surgical decision‑making after AVS. AVS should be advised for all patients with bilateral adrenal PA who are willing to undergo adrenal surgery, which is conducive to correct lateral segmentation and improve treatment choices.

View Figures

View References

1	Reincke M, Bancos I, Mulatero P, Scholl UI, Stowasser M and Williams TA: Diagnosis and treatment of primary aldosteronism. Lancet Diabetes Endocrinol. 9:876–892. 2021.PubMed/NCBI View Article : Google Scholar
2	Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, Young WF Jr and Montori VM: Endocrine Society. Case detection, diagnosis, and treatment of patients with primary aldosteronism: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 93:3266–3281. 2008.PubMed/NCBI View Article : Google Scholar
3	Williams TA, Burrello J, Sechi LA, Fardella CE, Matrozova J, Adolf C, Baudrand R, Bernardi S, Beuschlein F, Catena C, et al: Computed tomography and adrenal venous sampling in the diagnosis of unilateral primary aldosteronism. Hypertension. 72:641–649. 2018.PubMed/NCBI View Article : Google Scholar
4	Kempers MJ, Lenders JW, van Outheusden L, van der Wilt GJ, Schultze Kool LJ, Hermus AR and Deinum J: Systematic review: Diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism. Ann Intern Med. 151:329–337. 2009.PubMed/NCBI View Article : Google Scholar
5	Ishidoya S, Kaiho Y, Ito A, Morimoto R, Satoh F, Ito S, Ishibashi T, Nakamura Y, Sasano H and Arai Y: Single-center outcome of laparoscopic unilateral adrenalectomy for patients with primary aldosteronism: Lateralizing disease using results of adrenal venous sampling. Urology. 78:68–73. 2011.PubMed/NCBI View Article : Google Scholar
6	Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, Stowasser M and Young WF Jr: The management of primary aldosteronism: Case detection, diagnosis, and treatment: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 101:1889–1916. 2016.PubMed/NCBI View Article : Google Scholar
7	Williams TA, Lenders JWM, Mulatero P, Burrello J, Rottenkolber M, Adolf C, Satoh F, Amar L, Quinkler M, Deinum J, et al: Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol. 5:689–699. 2017.PubMed/NCBI View Article : Google Scholar
8	Sarlon-Bartoli G, Michel N, Taieb D, Mancini J, Gonthier C, Silhol F, Muller C, Bartoli JM, Sebag F, Henry JF, et al: Adrenal venous sampling is crucial before an adrenalectomy whatever the adrenal-nodule size on computed tomography. J Hypertens. 29:1196–1202. 2011.PubMed/NCBI View Article : Google Scholar
9	Cesari M, Seccia TM, Maiolino G and Rossi GP: Primary aldosteronism in elderly, old, and very old patients. J Hum Hypertens. 34:807–813. 2020.PubMed/NCBI View Article : Google Scholar
10	Rossi GP, Cesari M, Lenzini L and Seccia TM: Disease monitoring of primary aldosteronism. Best Pract Res Clin Endocrinol Metab. 34(101417)2020.PubMed/NCBI View Article : Google Scholar
11	Young WF, Stanson AW, Thompson GB, Grant CS, Farley DR and van Heerden JA: Role for adrenal venous sampling in primary aldosteronism. Surgery. 136:1227–1235. 2004.PubMed/NCBI View Article : Google Scholar
12	O'Toole SM, Sze WC, Chung TT, Akker SA, Druce MR, Waterhouse M, Pitkin S, Dawnay A, Sahdev A, Matson M, et al: Low-grade cortisol cosecretion has limited impact on ACTH-stimulated AVS parameters in primary aldosteronism. J Clin Endocrinol Metab. 105(dgaa519)2020.PubMed/NCBI View Article : Google Scholar
13	Rossi GP, Auchus RJ, Brown M, Lenders JW, Naruse M, Plouin PF, Satoh F and Young WF Jr: An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 63:151–160. 2014.PubMed/NCBI View Article : Google Scholar
14	Rossi GP, Barisa M, Allolio B, Auchus RJ, Amar L, Cohen D, Degenhart C, Deinum J, Fischer E, Gordon R, et al: The adrenal vein sampling international study (AVIS) for identifying the major subtypes of primary aldosteronism. J Clin Endocrinol Metab. 97:1606–1614. 2012.PubMed/NCBI View Article : Google Scholar
15	Mulatero P, Stowasser M, Loh KC, Fardella CE, Gordon RD, Mosso L, Gomez-Sanchez CE, Veglio F and Young WF Jr: Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents. J Clin Endocrinol Metab. 89:1045–1050. 2004.PubMed/NCBI View Article : Google Scholar
16	Citton M, Viel G, Rossi GP, Mantero F, Nitti D and Iacobone M: Outcome of surgical treatment of primary aldosteronism. Langenbecks Arch Surg. 400:325–331. 2015.PubMed/NCBI View Article : Google Scholar
17	Zarnegar R, Bloom AI, Lee J, Kerlan RK Jr, Wilson MW, Laberge JM, Gordon RL, Kebebew E, Clark OH and Duh QY: Is adrenal venous sampling necessary in all patients with hyperaldosteronism before adrenalectomy? J Vasc Interv Radiol. 19:66–71. 2008.PubMed/NCBI View Article : Google Scholar
18	Wolley M, Thuzar M and Stowasser M: Controversies and advances in adrenal venous sampling in the diagnostic workup of primary aldosteronism. Best Pract Res Clin Endocrinol Metab. 34(101400)2020.PubMed/NCBI View Article : Google Scholar