Antecubital vein combined with femoral vein pathway could shorten the learning curve of simultaneous bilateral adrenal vein sampling

Jiaqi Liu; Shuai Shao; Qiuli Wang; Zhiping Zhang; Xiaoying Ding; Li Zhao; Jinliang Wang; Xiaohong Ji; Qiuyan Dai; Mingli Du; Zhi Zhang

doi:10.1111/jch.14828

Antecubital vein combined with femoral vein pathway could shorten the learning curve of simultaneous bilateral adrenal vein sampling

J Clin Hypertens (Greenwich). 2024 May 15. doi: 10.1111/jch.14828. Online ahead of print.

Authors

Jiaqi Liu¹, Shuai Shao¹, Qiuli Wang², Zhiping Zhang¹, Xiaoying Ding³, Li Zhao³, Jinliang Wang⁴, Xiaohong Ji², Qiuyan Dai¹, Mingli Du², Zhi Zhang¹

Affiliations

¹ Department of Cardiology, Shanghai General Hospital (originally named Shanghai First People's Hospital), Shanghai Jiaotong University School of medicine, Shanghai, China.
² Department of Nursing, Shanghai General Hospital (originally named Shanghai First People's Hospital), Shanghai Jiaotong University School of medicine, Shanghai, China.
³ Department of Endocrinology, Shanghai General Hospital (originally named Shanghai First People's Hospital), Shanghai Jiaotong University School of medicine, Shanghai, China.
⁴ School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.

PMID: 38751037
DOI: 10.1111/jch.14828

Abstract

During our previous bilateral adrenal vein sampling (AVS) procedure, the authors observed that accessing the left adrenal vein through the antecubital vein was more feasible than the conventional femoral vein. Meanwhile, the femoral vein pathway facilitated access to the right adrenal vein than the antecubital vein pathway. Therefore, the authors hypothesized that simultaneous bilateral AVS via the antecubital combined with the femoral vein pathway could improve the success rate. A total of 94 cases of AVS via the antecubital combined with the femoral vein pathway were performed, while the remaining 20 cases employed the antecubital vein pathway at our center between August 2020 and April 2023. Furthermore, a meta-analysis was conducted in this study using 15 selected articles to determine the success rate of AVS in each center and pathway. The success rate of ACTH-stimulated simultaneous bilateral AVS via the antecubital vein combined with the femoral vein pathway was 92.85% (P = .503) on the right and 95.00% (P < .001) on the left. In the antecubital vein pathway, the success rates were only 25.00% (P < .001) on the right side and 80.00% (P = .289) on the left side. The results of meta-analysis demonstrated a success rate of 78.16% on the right and 94.98% on the left for ACTH-stimulated AVS via the femoral vein pathway. Based on our center's experience, simultaneous bilateral adrenal vein sampling via the combined pathway could improve the success rate of AVS in the short term and shorten the learning curve.

Keywords: adrenal vein sampling (AVS); lateral index (LI); primary hyperaldosteronism (PA); secondary high blood pressure (HBP); selection index (SI).

Abstract

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