Techniques of adrenal venous sampling in patients with inferior vena cava or renal vein anomalies

Jpn J Radiol. 2018 Jun;36(6):407-413. doi: 10.1007/s11604-018-0732-5. Epub 2018 Apr 3.

Abstract

Purpose: To review the techniques and technical success rate of adrenal venous sampling (AVS) in patients with inferior vena cava (IVC) or renal vein anomalies.

Materials and methods: The techniques and success rate of AVS in 15 patients with anomalies [8 with double IVC (dIVC), 3 with left IVC (ltIVC), 2 with retroaortic left renal vein (LRV), and 2 with circumaortic LRV] underwent AVS was retrospectively reviewed.

Results: Among 11 patients with IVC anomalies, the success rates for sampling the right and left adrenal veins (RAV and LAV) were 81.8 and 90.9%, respectively. In dIVC, the LAV was selected using the following four methods: approaching through the right IVC from the right femoral vein, flipping the LAV catheter tip in the LRV (n = 4) or the interiliac-communicating vein (n = 1), or through the ltIVC from the right (n = 1) or left (n = 2) femoral vein. Among the four patients with LRV anomalies, the success rate was 100% for each adrenal vein.

Conclusion: AVS can be successfully performed in patients with anomalies. The key to technical success is understanding the venous anatomy based on pre-procedural CT images and choosing appropriate methods.

Keywords: AVS; Adrenal venous sampling; Interventional radiology; Primary aldosteronism; Venous anomalies.

MeSH terms

  • Adrenal Glands / blood supply*
  • Adult
  • Catheterization / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Renal Veins / abnormalities*
  • Renal Veins / diagnostic imaging*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Vena Cava, Inferior / abnormalities*
  • Vena Cava, Inferior / diagnostic imaging*
  • Young Adult