Success rate of adrenal venous sampling and predictors for success: a retrospective study

Purpose
To report the success rate of adrenal venous sampling (AVS) and identify the predictors for procedural success.

Material and methods
Sixty-four patients (18 men and 46 women) with a mean ± SD age of 50 ± 11.8 years (range 28-69 years) diagnosed as primary hyperaldosteronism, and who underwent AVS from January 2009 to December 2016, were retrospectively reviewed. In our institution, the initial period to perform the AVS was set from 2009 to 2013, and the post-initial period was defined as procedures performed after 2013. Successful sampling was determined when the ratio of cortisol from the adrenal vein to the level of cortisol in the inferior vena cava ≥ 5. The procedural success and subject factors between success and failure were analysed. A p value < 0.05 was considered statistically significant.

Results
The success rate of bilateral AVS was 71.9%. The success rates of right and left AVS were 76.6% and 90.6%, respectively. Male patients were more likely to succeed than female patients (adjusted odds ratio [aOR], 9.83; 95% confidence interval [CI], 1.14-85.14; p = 0.009). In our institution, the procedure performed in the post-initial period also succeeded more often compared to the initial period (aOR, 5.05; 95% CI, 1.2-21.16; p = 0.017). No other factors were associated with the success rate in this study.

Conclusions
The success rate of bilateral AVS in our institution was rather high. Male gender and procedure performed in the post-initial period were significant predictive factors for a successful procedure.