Parathyroid localization in patients with previous neck surgery.

The results of parathyroid arteriography and venous parathyroid hormone assay were evaluated in thirteen patients reexplored for persistent or recurrent hyperparathyroidism. The operative findings in these patients were ten adenomas and eight hyperplastic parathyroid glands. Angiography disclosed eight of the adenomas and failed to visualize one. Only two of the hyperplastic glands were disclosed by angiography. By venous sampling the correct side was predicted in seven out of eight cases of unilateral lesions--in one case of an adenoma no hormonal maximum was found. In two cases of bilateral lesions a maximum was found on one side only, while in three cases of unilateral two-lesions the maximum was correct in two cases and contralateral in one. We conclude that a combination of angiography and venous sampling gave localization or lateralisation in 12/13 patients with previous neck surgery for hyperparathyroidism and found the methods to be complementary to each other and prefer both done in these cases.