Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
J Interv Cardiol. 2023 Aug 12;2023:8670365. doi: 10.1155/2023/8670365. eCollection 2023.
To evaluate the safety and efficacy of adrenal venous sampling (AVS) via the cubital vein and femoral vein synchronously.
A total of 200 patients with primary aldosteronism admitted to the First Hospital of Fujian Medical University were enrolled and randomly divided into a single-path AVS group (SP, = 108) and a multipath AVS group (MP, = 92). We analyzed the clinical characteristics, intubation success rate, procedure cost, total fluoroscopy time, complications, contrast dosage, and the number of catheters selected during AVS. A planar quadrant system was established to mark the direction of the adrenal opening, with the intersection of the right renal vein and the inferior vena cava defined as the origin. In digital subtraction angiography images, the RAV opening located in the 0-3 o'clock direction was the first quadrant (I), and the 3-6 o'clock direction was the third quadrant (III).
There was no statistical difference between the two groups at baseline. Multipath AVS had a significantly higher success rate of right-sided intubation than single-path AVS (success rate of right-sided intubation/%: SP 87.96 vs MP 95.65, = 0.043). Total fluoroscopy time was significantly reduced (fluoroscopy time/min: SP 9.80 ± 4.07 vs MP 7.42 ± 3.48, = 0.024) and the cost of the procedure was markedly lower (cost/yuan: SP 3,900.93 ± 1,191.12 vs MP 3,378.26 ± 399.40, < 0.001). There was no significant difference in postoperative complications between the two groups. In the group I, the procedure was completed mainly with an MPA catheter (catheter selection/%: MPA 98.19 vs TIG 17.65, < 0.001). In the group III, TIG catheters were used more frequently (catheter selection/%: MPA 1.81 vs TIG 82.35, < 0.001).
Multipath AVS via the cubital vein and femoral vein improves the success rate of AVS with comparable safety compared to single-path AVS. When the RAV is opened in the III quadrant, the TIG catheter improves the cannulation success rate. The multipath AVS method provides more catheter options. Patients diagnosed with PA at the First Hospital of Fujian Medical University from December 2019 to December 2021 were included. The collection of medical records of the included population was approved by the ethics committee (approval number: [2021] 311). This was a cross-sectional study in which some patients were treated surgically and some were treated with superselective adrenal artery embolization (SAAE). We conducted a cohort study of patients treated with SAAE. ClinicalTrials.gov Protocol Registration and Results System (PRS) receipt release date: January 11, 2022. This trial is registered with NCT05188872.
评估经肘窝静脉和股静脉同步进行肾上腺静脉采样（AVS）的安全性和有效性。
共纳入 200 例福建医科大学附属第一医院就诊的原发性醛固酮增多症患者，随机分为单路 AVS 组（SP，n=108）和多路 AVS 组（MP，n=92）。分析两组患者的临床特征、插管成功率、手术费用、总透视时间、并发症、造影剂用量及 AVS 时选择的导管数量。建立平面四分象限系统，以右肾静脉与下腔静脉的交点为原点。在数字减影血管造影图像中，RAV 开口位于 0-3 点钟方向的为第一象限（I），3-6 点钟方向的为第三象限（III）。
两组患者基线资料比较差异无统计学意义。与单路 AVS 相比，多路 AVS 右侧插管成功率更高（右侧插管成功率/%：SP 87.96 vs MP 95.65， = 0.043）。总透视时间明显减少（透视时间/min：SP 9.80±4.07 vs MP 7.42±3.48， = 0.024），手术费用显著降低（手术费用/元：SP 3900.93±1191.12 vs MP 3378.26±399.40， ＜0.001）。两组患者术后并发症发生率比较差异无统计学意义。在象限 I 中，主要使用 MPA 导管完成手术（导管选择/%：MPA 98.19 vs TIG 17.65， ＜0.001）。在象限 III 中，TIG 导管的使用率更高（导管选择/%：MPA 1.81 vs TIG 82.35， ＜0.001）。
与单路 AVS 相比，经肘窝静脉和股静脉的多路 AVS 可提高 AVS 成功率，且安全性相当。当 RAV 开口位于 III 象限时，TIG 导管可提高插管成功率。多路 AVS 方法提供了更多的导管选择。该研究纳入了 2019 年 12 月至 2021 年 12 月在福建医科大学附属第一医院诊断为 PA 的患者。纳入人群的病历收集经伦理委员会批准（批准文号：[2021]311）。这是一项横断面研究，部分患者接受了手术治疗，部分患者接受了超选择性肾上腺动脉栓塞术（SAAE）治疗。我们对接受 SAAE 治疗的患者进行了队列研究。ClinicalTrials.gov 方案注册和结果系统（PRS）发布日期：2022 年 1 月 11 日。该试验在 ClinicalTrials.gov 注册，编号为 NCT05188872。
