Adrenal Vein Sampling for Primary Aldosteronism: A 2-Week Protocol for Withdrawal of Renin-Stimulating Antihypertensives.

Abstract:

OBJECTIVE:For evaluation of primary aldosteronism, international guidelines recommend a 4-6 week withdrawal of spironolactone, eplerenone, and amiloride prior to adrenal vein sampling (AVS). It is not always feasible to withdraw these drugs in patients with severe hypertension and hypokalemia. We present our experience evaluating the efficacy and clinical outcomes of a 2-week protocol for withdrawal of renin-stimulating antihypertensives prior to AVS. DESIGN:A single-center retrospective review of all patients who underwent AVS for primary aldosteronism between January 2014 and December 2015. PATIENTS:32 patients (24 M:8F, mean age 54y) underwent AVS with the 2-week protocol, and 32 held their renin-stimulating antihypertensives for 2 weeks instead of the recommended 4-6 weeks. MEASUREMENTS:Plasma renin activity (PRA) was measured immediately before venous sampling to assess for renin suppression (PRA < 0.5 ng/ml/hr). Demographics, antihypertensive medications, plasma aldosterone, plasma renin activity, and outcomes were reviewed. RESULTS:100% of procedures were diagnostic (selectivity index ≥ 3) and lateralization (lateralization index ≥ 4) was confirmed in 22/32 patients. 19/32 patients had contralateral suppression. PRA confirmed to be suppressed in 30/32 (94%) of patients. Of the 2 patients with unsuppressed renin, 1/2 lateralized diagnosing an aldosterone producing adenoma. CONCLUSIONS:Renin was suppressed in nearly all patients following a 2-week withdrawal of renin-stimulating antihypertensives. Patients who cannot tolerate stopping these medications for 4-6 weeks as recommended by current guidelines may undergo a 2-week withdrawal without affecting the diagnostic outcome of AVS, provided renin suppression is confirmed. LEVEL OF EVIDENCE:Level 4, Case Series.

authors

Ching KC,Cohen DL,Fraker DL,Trerotola SO

doi

10.1007/s00270-017-1637-x

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

1367-1371

issue

9

eissn

0174-1551

issn

1432-086X

pii

10.1007/s00270-017-1637-x

journal_volume

40

pub_type

杂志文章
  • Angioplasty after laser perforation.

    abstract::Perforation is the most important complication of laser angioplasty and leads to a decrease in success because the procedure has to be discontinued. In 3 patients we continued despite perforation and were able to stop extravasation with percutaneous transluminal angioplasty (PTA) and to finish the procedure with a goo...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/BF02577707

    authors: Reekers JA,Sprangers RL,van de Kley AJ

    更新日期:1991-03-01 00:00:00

  • Embolization of a high-output postnephrectomy aortocaval fistula with Gianturco coils and cyanoacrylate.

    abstract::The authors describe the endovascular treatment of a high-output, large-caliber, postnephrectomy aortocaval fistula using a mixture of cyanoacrylate and lipiodol combined with Gianturco coil embolization. Thirty-nine coils were used to decrease the flow through the fistula so that a fast-polymerizing glue mixture coul...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/BF02560151

    authors: Cekirge S,Oguzkurt L,Saatçi I,Boyvat F,Balkanci F

    更新日期:1996-01-01 00:00:00

  • Pulmonary arterial stent implantation in an adult with Williams syndrome.

    abstract::We report a 38-year-old patient who presented with pulmonary hypertension and right ventricular dysfunction due to pulmonary artery stenoses as a manifestation of Williams syndrome, mimicking chronic thromboembolic pulmonary hypertension. The patient was treated with balloon angioplasty and stent implantation. Short-t...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-007-9009-6

    authors: Reesink HJ,Henneman OD,van Delden OM,Biervliet JD,Kloek JJ,Reekers JA,Bresser P

    更新日期:2007-07-01 00:00:00

  • Thoracic Duct Embolization in Post-neck Dissection Chylous Leakage: A Case Series of Six Patients and Review of the Literature.

    abstract::Chylous leak is a serious complication of neck dissection. Patients are often managed conservatively, and failure of conservative management necessitates surgical management, which adds to their morbidity. We present a case series demonstrating the value of thoracic duct embolization (TDE) in management of patients wi...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00270-020-02475-9

    authors: Moussa AM,Maybody M,Gonzalez-Aguirre AJ,Buicko JL,Shaha AR,Santos E

    更新日期:2020-06-01 00:00:00

  • Use of a snare wire to perform nephrostomy access in the presence of obstructive staghorn calculi.

    abstract::We describe a technique for gaining access to the central collecting system via a chosen calyx, utilizing an alternative entry point to that calyx. An Amplatz nitinol loop snare is then used to convert this access to a traditional approach. ...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:

    authors: Nosher JL,Siegel RL,Bodner LJ

    更新日期:1996-05-01 00:00:00

  • Mortality and Rates of Secondary Intervention After EVAR in an Unselected Population: Influence of Simple Clinical Categories and Implications for Surveillance.

    abstract:INTRODUCTION:Post-EVAR surveillance has a major impact upon patients, carers and healthcare resources. We hypothesised that elective indication, on-IFU anatomy, use of a modern device or normal first CTA, or a combination of these categories, might predict a rate of secondary intervention low enough to alter current su...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-016-1303-8

    authors: Hammond CJ,Shah AH,Snoddon A,Patel JV,Scott DJ

    更新日期:2016-06-01 00:00:00

  • Use of digital video coronary arteriography in the performance of percutaneous transluminal coronary angioplasty.

    abstract::Digital video coronary arteriography (DVCA) was used in 59 cases of percutaneous transluminal coronary angioplasty (PTCA) and found to be useful for display of imagery to facilitate choice of approach to a stenotic lesion; providing a "road map," simplifying guide wire manipulation and selective catheterization of ves...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/BF02577966

    authors: Boxt LM,Meyerovitz MF,Taus RH,Harrington DP,Ganz P,Friedman PL,Levin DC

    更新日期:1987-01-01 00:00:00

  • Local Control and Analgesic Efficacy of Percutaneous Cryoablation for Desmoid Tumors.

    abstract:OBJECTIVE:Cryoablation is being more and more often used to treat desmoid tumors. We report our experience of cryoablation as a local and analgesic treatment for inoperable or recurring desmoid tumors. METHODS:This study includes 34 patients who underwent percutaneous cryoablation of 41 desmoid tumors between July 201...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-019-02323-5

    authors: Bouhamama A,Lame F,Mastier C,Cuinet M,Thibaut A,Beji H,Ricoeur A,Blay JY,Pilleul F

    更新日期:2020-01-01 00:00:00

  • Cutting-balloon angioplasty versus balloon angioplasty as treatment for short atherosclerotic lesions in the superficial femoral artery: randomized controlled trial.

    abstract:PURPOSE:To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. MATERIAL AND METHODS:The study group comp...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s00270-013-0603-5

    authors: Poncyljusz W,Falkowski A,Safranow K,Rać M,Zawierucha D

    更新日期:2013-12-01 00:00:00

  • Fatal intraventricular hemorrhage after the extracranial carotid artery angioplasty and stent placement.

    abstract::We report on a 72-year-old female with an unusual intracranial bleeding complication after an extracranial carotid artery stenting procedure performed for a tight left ICA stenosis associated with contralateral carotid occlusion. Two hours after the procedure, the initial signs of intracranial bleeding appeared that l...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-004-0155-9

    authors: Krajickova D,Krajina A,Nova M,Raupach J

    更新日期:2005-07-01 00:00:00

  • Chemotherapy, Still an Option in the Twenty-First Century in Metastatic Colorectal Cancer?

    abstract::Substantial improvements have been made in the systemic treatment of colorectal cancer over the last two decades. Median overall survival (OS) of patients with metastatic colorectal cancer (mCRC) has been constantly increased and the most recent first-line studies exceeded the 30-month median overall survival. The sta...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章,评审

    doi:10.1007/s00270-019-02278-7

    authors: Eisterer W,Prager G

    更新日期:2019-09-01 00:00:00

  • Magnetic resonance imaging (MRI) analysis of fibroid location in women achieving pregnancy after uterine artery embolization.

    abstract::The purpose of this study was to evaluate the fibroid morphology in a cohort of women achieving pregnancy following treatment with uterine artery embolization (UAE) for symptomatic uterine fibroids. A retrospective review of magnetic resonance imaging (MRI) of the uterus was performed to assess pre-embolization fibroi...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-007-9118-2

    authors: Walker WJ,Bratby MJ

    更新日期:2007-09-01 00:00:00

  • Preoperative direct puncture embolization of advanced juvenile nasopharyngeal angiofibroma in combination with transarterial embolization: an analysis of 22 consecutive patients.

    abstract:OBJECTIVE:This study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). METHODS:The study included 22 patients. An 18-gauge needl...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-012-0404-2

    authors: Lv MM,Fan XD,Su LX,Chen D

    更新日期:2013-02-01 00:00:00

  • A migrated aortic stent graft causing erosive spondylopathy.

    abstract::We report about a patient presenting with back pain 4 months after an uneventful endovascular implantation of an aortic stent graft. Computed tomography scan revealed a migration of the stent with consecutive endoleakage, kink formation, and movement of the stent toward the spine, which caused destruction of the aorti...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-013-0695-y

    authors: Gestrich C,Probst C,Wilhelm K,Schiller W

    更新日期:2013-12-01 00:00:00

  • Analysis of particle size generated during plaque ablation with a flashlamp pumped pulsed dye laser.

    abstract:PURPOSE:To examine debris size generated during in vitro plaque ablation by laser energy and estimate the risk of peripheral embolization following laser angioplasty. METHODS:A flashlamp pumped pulsed dye laser of 480-nm wavelength was used to ablate calcified arteriosclerotic plaque, fibrous fatty plaque, and normal ...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/BF02807353

    authors: Froelich JJ,Möckel JW,Azumi N,Barth KH

    更新日期:1995-01-01 00:00:00

  • Endovascular management of visceral artery pseudoaneurysms: transcatheter coil embolization using the isolation technique.

    abstract:PURPOSE:To describe our experiences with treatment of visceral artery pseudoaneurysms (VAPA) by transcatheter coil embolization using an isolation technique and to propose indications for treating VAPA with this method. MATERIALS AND METHODS:We treated 37 patients with VAPA endovascularly: There were 15 pancreaticoduo...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-010-9973-0

    authors: Ikeda O,Nakasone Y,Tamura Y,Yamashita Y

    更新日期:2010-12-01 00:00:00

  • Percutaneous angioplasty for atherosclerotic renal artery disease: effect on renal function in azotemic patients.

    abstract:PURPOSE:We studied the effect of percutaneous transluminal renal angioplasty (PTRA) on renal function in azotemic patients with atherosclerotic renal artery stenosis. METHODS:The results of PTRA were analyzed retrospectively in 40 patients. There were 61 stenoses, 54 of which received balloon angioplasty; 7 had stent ...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/BF00195507

    authors: Pattynama PM,Becker GJ,Brown J,Zemel G,Benenati JF,Katzen BT

    更新日期:1994-05-01 00:00:00

  • Guenther tulip filter retrieval from a left-sided inferior vena cava.

    abstract::Optional (retrievable) inferior cava filters (IVC) may have advantages over permanent filters in a certain subset of patients, especially in view of recent concerns about the long-term thrombotic complications of the latter. Retrieval of the Guenther Tulip Filter (GTF), an optional filter, has been reported in a total...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-003-2677-y

    authors: Brountzos EN,Kaufman JA,Lakin PL

    更新日期:2004-01-01 00:00:00

  • Adrenal radiofrequency ablation in swine: change in blood pressure and histopathologic analysis.

    abstract:PURPOSE:To evaluate changes in blood pressure during adrenal radiofrequency ablation (RFA) and analyze histopathologic outcomes in swine adrenal glands. MATERIALS AND METHODS:Animal Care Committee approval was obtained for this study. After laparotomy, a single adrenal gland was ablated from each of six animals (six R...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-010-0078-6

    authors: Yamakado K,Takaki H,Uchida K,Nakatsuka A,Shiraishi T,Takeda K

    更新日期:2011-08-01 00:00:00

  • Comparison of digital with conventional ventriculography for quantitative right ventricular studies.

    abstract::To assess the feasibility of quantitative central venous digital angiocardiography, right ventricular spatial orientation, size, and shape were compared with measurements based on conventional angiocardiography, both obtained during routine cardiac catheterization in 21 children with various congenital heart defects. ...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/BF02577015

    authors: Lange PE,Radtke W,Fellows KE,Onnasch DG,Heintzen PH

    更新日期:1988-01-01 00:00:00

  • Endovascular treatment of descending thoracic aortic aneurysms with the EndoFit stent-graft.

    abstract:OBJECTIVE:To evaluate the mid-term feasibility, efficacy, and durability of descending thoracic aortic aneurysm (DTAA) exclusion using the EndoFit device (LeMaitre Vascular). METHODS:Twenty-three (23) men (mean age 66 years) with a DTAA were admitted to our department for endovascular repair (21 were ASA III+ and 2 re...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-006-0168-7

    authors: Saratzis N,Saratzis A,Melas N,Ginis G,Lioupis A,Lykopoulos D,Lazaridis J,Kiskinis D

    更新日期:2007-03-01 00:00:00

  • Development of a new hanging-type esophageal stent for preventing migration: a preliminary study in an animal model of esophagotracheal fistula.

    abstract:PURPOSE:Covered, self-expandable metallic stents (SEMS) have been enthusiastically adopted for the treatment of esophagotracheal fistula, but problems with stent migration have yet to be resolved. To overcome this problem, we have developed a new hanging-type esophageal stent designed to prevent migration, and we condu...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-011-0240-9

    authors: Endo M,Kaminou T,Ohuchi Y,Sugiura K,Yata S,Adachi A,Kawai T,Takasugi S,Yamamoto S,Matsumoto K,Hashimoto M,Ihaya T,Ogawa T

    更新日期:2012-10-01 00:00:00

  • Long-term safety and effectiveness of the "OptEase" vena cava filter.

    abstract:PURPOSE:To assess the long-term safety and effectiveness of the OptEase inferior vena cava (IVC) filter. MATERIALS AND METHODS:In this Institutional Review Board-approved, retrospective study, we reviewed data of 71 patients who received an OptEase filter at our institution from 2002 to 2007. Thirty-nine (55%) patient...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-010-9969-9

    authors: Kalva SP,Marentis TC,Yeddula K,Somarouthu B,Wicky S,Stecker MS

    更新日期:2011-04-01 00:00:00

  • A newly developed perfused umbrella electrode for radiofrequency ablation: an ex vivo evaluation study in bovine liver.

    abstract::The purpose of this study was to evaluate the effectiveness of a newly developed perfused monopolar radiofrequency (RF) probe with an umbrella-shaped array. A perfused umbrella-shaped monopolar RF probe based on a LeVeen electrode (Boston Scientific Corp., Natick, MA, USA) with a 3-cm array diameter was developed. Fiv...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-007-9125-3

    authors: Bruners P,Pfeffer J,Kazim RM,Günther RW,Schmitz-Rode T,Mahnken AH

    更新日期:2007-09-01 00:00:00

  • Successful embolization of a spontaneous mesocaval shunt using the Amplatzer Vascular Plug II.

    abstract::A 48-year-old man with alcoholic liver cirrhosis and hepatic encephalopathy was found to have a large, spontaneous mesocaval shunt. The shunt was successfully occluded with the use of an Amplatzer Vascular Plug. To our knowledge, this is the first report of the use of this device to embolize a mesocaval shunt involvin...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-009-9739-8

    authors: Boixadera H,Tomasello A,Quiroga S,Cordoba J,Perez M,Segarra A

    更新日期:2010-10-01 00:00:00

  • Improvements in Irritative Versus Obstructive Symptoms of the International Prostate Symptom Score After Prostatic Artery Embolization in 174 Patients, in a Single Center.

    abstract:AIM:The aim of this study is to compare the improvements in irritative versus obstructive symptoms of the International Prostate Symptom Score (IPSS) after prostatic artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS:Between 2010 and 2018, 186 patients underwent PAE in...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-019-02398-0

    authors: Moreira AM,de Assis AM,Carnevale FC,Oliveira DS,Antunes AA

    更新日期:2020-04-01 00:00:00

  • Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience.

    abstract::The purpose of the study was to evaluate the feasibility, safety, and therapeutic effects of the combination of renal arterial embolization and radiofrequency (RF) ablation to reinforce the anticancer effect on renal cell carcinomas (RCCs) measuring 3.5 cm or larger. This study was undertaken to evaluate this combined...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-004-0090-9

    authors: Yamakado K,Nakatsuka A,Kobayashi S,Akeboshi M,Takaki H,Kariya Z,Kinbara H,Arima K,Yanagawa M,Hori Y,Kato H,Sugimura Y,Takeda K

    更新日期:2006-05-01 00:00:00

  • Angioplasty in stenosis of the innominate artery.

    abstract::We describe a successful percutaneous transluminal dilatation (PTD) of an innominate artery stenosis in a 40-year-old patient with aortic arch syndrome. Five years earlier both a left central carotid artery occlusion and an innominate and left subclavian artery stenosis were treated by grafting from the aorta to the d...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/BF02552777

    authors: Kobinia GS,Bergmann H Jr

    更新日期:1983-01-01 00:00:00

  • Treatment of benign tracheal stenosis utilizing self-expanding nitinol stents.

    abstract::We assessed the results of self-expanding metallic stent insertion into benign proximal tracheal stenosis in patients not appropriate or unfit for surgical repair. Proximal benign tracheal stenoses had occurred in 11 patients (7 men, 4 women, mean age 68.8 years) after long-time intubation (n = 6), tracheostomy (n = 4...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-004-0091-8

    authors: Sesterhenn AM,Wagner HJ,Alfke H,Werner JA,Lippert BM

    更新日期:2004-07-01 00:00:00

  • Use of Accessory Hepatic Vein Intervention in the Treatment of Budd-Chiari Syndrome.

    abstract:PURPOSE:To evaluate the clinical value of accessory hepatic vein (AHV) intervention in the treatment of Budd-Chiari syndrome (BCS). PATIENTS AND METHODS:From August 2008 to July 2014, consecutive patients with BCS caused by obstruction of three hepatic veins (HVs) with or without obstruction of inferior vena cava (IVC...

    journal_title:Cardiovascular and interventional radiology

    pub_type: 杂志文章

    doi:10.1007/s00270-015-1105-4

    authors: Fu YF,Wei N,Wu Q,Zhang QQ,Cui YF,Xu H

    更新日期:2015-12-01 00:00:00