TY - JOUR
T1 - The adrenal vein sampling International study (avis) for identifying the major subtypes of primary aldosteronism
AU - Rossi, Gian Paolo
AU - Barisa, Marlena
AU - Allolio, Bruno
AU - Auchus, Richard J.
AU - Amar, Laurence
AU - Cohen, Debbie
AU - Degenhart, Christoph
AU - Deinum, Jaap
AU - Fischer, Evelyn
AU - Gordon, Richard
AU - Kickuth, Ralph
AU - Kline, Gregory
AU - Lacroix, Andre
AU - Magill, Steven
AU - Miotto, Diego
AU - Naruse, Mitsuhide
AU - Nishikawa, Tetsuo
AU - Omura, Masao
AU - Pimenta, Eduardo
AU - Plouin, Pierre Francois
AU - Quinkler, Marcus
AU - Reincke, Martin
AU - Rossi, Ermanno
AU - Rump, Lars Christian
AU - Satoh, Fumitoshi
AU - Kool, Leo Schultze
AU - Seccia, Teresa Maria
AU - Stowasser, Michael
AU - Tanabe, Akiyo
AU - Trerotola, Scott
AU - Vonend, Oliver
AU - Widimsky, Jiri
AU - Wu, Kwan Dun
AU - Wu, Vin Cent
AU - Pessina, Achille Cesare
PY - 2012/5
Y1 - 2012/5
N2 - Context: In patients who seek surgical cure of primary aldosteronism (PA), The Endocrine Society Guidelines recommend the use of adrenal vein sampling (AVS), which is invasive, technically challenging, difficult to interpret, and commonly held to be risky. Objective: The aim of this study was to determine the complication rate of AVS and the ways in which it is performed and interpreted at major referral centers. Design and Settings: The Adrenal Vein Sampling International Study is an observational, retrospective, multicenter study conducted at major referral centers for endocrine hypertension worldwide. Participants: Eligible centers were identified from those that had published on PA and/or AVS in the last decade. Main Outcome Measure: The protocols, interpretation, and costs of AVS were measured, as well as the rate of adrenal vein rupture and the rate of use of AVS. Results: Twenty of 24 eligible centers from Asia, Australia, North America, and Europe participated and provided information on 2604 AVS studies over a 6-yr period. The percentage of PA patients systematically submitted to AVS was 77% (median; 19-100%, range). Thirteen of the 20 centers used sequential catheterization, and seven used bilaterally simultaneous catheterization; cosyntropin stimulation was used in 11 centers. The overall rate of adrenal vein rupture was 0.61%. It correlated directly with the number of AVS performed at a particular center (P = 0.002) and inversely with the number of AVS performed by each radiologist (P = 0.007). Conclusions: Despite carrying a minimal risk of adrenal vein rupture and at variance with the guidelines, AVS is not used systematically at major referral centers worldwide. These findings represent an argument for defining guidelines for this clinically important but technically demanding procedure.
AB - Context: In patients who seek surgical cure of primary aldosteronism (PA), The Endocrine Society Guidelines recommend the use of adrenal vein sampling (AVS), which is invasive, technically challenging, difficult to interpret, and commonly held to be risky. Objective: The aim of this study was to determine the complication rate of AVS and the ways in which it is performed and interpreted at major referral centers. Design and Settings: The Adrenal Vein Sampling International Study is an observational, retrospective, multicenter study conducted at major referral centers for endocrine hypertension worldwide. Participants: Eligible centers were identified from those that had published on PA and/or AVS in the last decade. Main Outcome Measure: The protocols, interpretation, and costs of AVS were measured, as well as the rate of adrenal vein rupture and the rate of use of AVS. Results: Twenty of 24 eligible centers from Asia, Australia, North America, and Europe participated and provided information on 2604 AVS studies over a 6-yr period. The percentage of PA patients systematically submitted to AVS was 77% (median; 19-100%, range). Thirteen of the 20 centers used sequential catheterization, and seven used bilaterally simultaneous catheterization; cosyntropin stimulation was used in 11 centers. The overall rate of adrenal vein rupture was 0.61%. It correlated directly with the number of AVS performed at a particular center (P = 0.002) and inversely with the number of AVS performed by each radiologist (P = 0.007). Conclusions: Despite carrying a minimal risk of adrenal vein rupture and at variance with the guidelines, AVS is not used systematically at major referral centers worldwide. These findings represent an argument for defining guidelines for this clinically important but technically demanding procedure.
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U2 - 10.1210/jc.2011-2830
DO - 10.1210/jc.2011-2830
M3 - Article
C2 - 22399502
AN - SCOPUS:84860776741
VL - 97
SP - 1606
EP - 1614
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 5
ER -