Adrenal venous sampling (AVS) is the criterion standard to distinguish between unilateral and bilateral adrenal disease in patients with primary aldosteronism (PA). Successful sampling from both adrenal veins is necessary for lateralization. The femoral vein is the only access for AVS in current period. We investigated the feasibility of a transforearm approach for AVS.Design and Method:
From August 2014 to August 2015, 48 PA patients underwent AVS via forearm vein by one cardiologist. After placing a 20-gauge angiocath in a superficial forearm vein, a 6-French vascular sheath was placed. We used a 5Fr MPA catheter (Cook Medical) for the right adrenal vein and a TIG catheter (Terumo Corporation) for the left adrenal vein. Cortisol and aldosterone levels were measured in blood samples from both adrenal veins.Results:
Adrenal venous sampling was technically successful in 45 (93.8%) patients on the right side and in all (100%) patients on the left side. The technical success rate of bilateral sides is 93.8%. Our success rate increased with experience, all 3 failed cases were occurred in earlier six months. In 45 cases whose AVS were successful, the mean selectivity index was 21.23 ± 16.16 on the right side and 10.14 ± 7.98 on the left.Conclusions:
AVS via the forearm veins is feasible and may be an alternative of the femoral venous access method.