Zhang Furong, Zhu Ni, Zhao Shuhua, Han Rui, Shi Juan, Luo Wenfeng, Shi Dong, Xin Xumin, Qian Jun
Department of Cardiovascular, The Second Affiliated Hospital of Chongqing Medical University, No. 74, Linjiang Road, Yuzhong District, Chongqing, 400010, China.
Sci Rep. 2025 Jan 2;15(1):337. doi: 10.1038/s41598-024-83377-5.
In order to provide some references for vein approach selection in adrenal vein sampling (AVS), this retrospective study analyzed 325 cases of primary aldosteronism (PA) patients who underwent AVS via the upper extremity vein approach, comparing the differences in complications and visual analogue scale (VAS) scores through median cubital vein (MCV), basilic vein (BV), and cephalic vein (CV). The results indicated no significant difference in the incidence of venous spasm (right MCV vs. right BV vs. left MCV vs. left BV: 4.2 vs. 5.9 vs. 5.3 vs. 0.0%, p>0.05) and VAS scores between AVS performed using the MCV and the BV. However, the right CV access was associated with a relatively higher incidence of venous spasm (right CV: 20% vs. right MCV: 4.2%, p<0.05) and higher rate of thrombosis formation (right CV: 5.7% vs. right MCV: 0.0%, p<0.05) than right MCV, accompanied by more severe pain. The study suggests that bilateral MCV and BV are both viable options vein access for AVS. When neither the MCV nor the BV on one side is accessible, it may be more prudent to opt for the MCV or BV on the contralateral side rather than the CV.
为了给肾上腺静脉采样（AVS）中静脉入路的选择提供一些参考，本回顾性研究分析了325例经上肢静脉入路行AVS的原发性醛固酮增多症（PA）患者，比较了经肘正中静脉（MCV）、贵要静脉（BV）和头静脉（CV）穿刺的并发症及视觉模拟评分（VAS）的差异。结果显示，使用MCV和BV进行AVS时，静脉痉挛的发生率（右MCV vs. 右BV vs. 左MCV vs. 左BV：4.2% vs. 5.9% vs. 5.3% vs. 0.0%，p>0.05）和VAS评分无显著差异。然而，右侧CV穿刺的静脉痉挛发生率相对较高（右CV：20% vs. 右MCV：4.2%，p<0.05），血栓形成率也高于右MCV（右CV：5.7% vs. 右MCV：0.0%，p<0.05），且疼痛更严重。该研究表明，双侧MCV和BV都是AVS可行的静脉入路选择。当一侧的MCV和BV均无法穿刺时，选择对侧的MCV或BV而非CV可能更为谨慎。
