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A feasibility study on percutaneous forearm vein access for adrenal venous sampling

Journal of Human Hypertension volume 31, pages 76–78 (2017)Cite this article

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Adrenal venous sampling (AVS) is the criterion standard to distinguish between unilateral and bilateral adrenal disease in patients with primary aldosteronism (PA). The femoral vein is the only currently used means of access for AVS. We investigated the feasibility of a transforearm approach for AVS. From August 2014 to August 2015, 48 PA patients underwent AVS via forearm vein by one cardiologist. AVS was technically successful in 45 (93.8%) patients on the right side and in all (100%) patients on the left side. This study suggested that AVS via the forearm veins is feasible, and may be an alternative to the femoral venous access method.

Primary aldosteronism (PA) is a common cause of secondary hypertension with a prevalence among hypertensives of ~10%.1, 2 Adrenal venous sampling (AVS) is considered the gold standard in differentiating unilateral from bilateral forms of PA.3 Currently, the only vascular access used for AVS is the femoral vein.4 When performed in experienced centres, AVS is associated with a low rate of complications. However, the most frequent complications are related to venous access. In parallel with the forearm venous approach for right heart catheterization to reduce access-site complications,5, 6 using a forearm vein for AVS has gained attention. However, no data regarding this access have been reported. In this study, we describe a new technique of AVS via forearm approach and assess the practical clinical applicability of this method in patients undergoing AVS.

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Authors and Affiliations

  1. Department of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    J Xu, C Sheng, M Li, X Tang, L Zhu, P Gao & J Wang

  2. Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    W Shen

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  1. J Xu
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  2. C Sheng
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  3. M Li
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  8. J Wang
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Correspondence to J Xu.

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Xu, J., Sheng, C., Li, M. et al. A feasibility study on percutaneous forearm vein access for adrenal venous sampling. J Hum Hypertens 31, 76–78 (2017). https://doi.org/10.1038/jhh.2016.41

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