Comparative Analysis of Single-Path and Multipath Adrenal Venous Sampling in Primary Aldosteronism

Figure 2

Techniques of using different catheters in single-path AVS and multipath AVS synchronously and asynchronously. (a) Inserted a 5F MPA catheter into the RAV in the single-path AVS group. (b) Inserted a 5F TIG catheter into the LAV in the single-path AVS group. Angiogram showed a thick common trunk vein formed by the confluence of the LAV and the PV. (c) To avoid local hemodilution of the LAV, a microcatheter was used to superselect into the LAV. Angiogram showed that the microcatheter superselected into the LAV. (d) 5F MPA catheter synchronously embedded in the RAV opening and in the LAV opening in the multipath AVS. (e) In anteroposterior position, intubated RAV through the cubital vein with a TIG catheter. (f) In right anterior oblique 30° angiography, the central venous opening of RAV was right oblique toward the III quadrant. (g) In anteroposterior position, intubated RAV with a MPA catheter via the femoral vein. (h) In right anterior oblique 30° angiography, the central venous opening of RAV was direct toward the III quadrant. Figures (e–h) show adrenal venography in the same patient in different positions. Figures (g, h) show that MPA catheter got through the femoral vein pathway and accurately positioned to the RAV with a total exposure time of 12.77 min. Figures (e, f) show that TIG catheter got through the cubital vein pathway, reaching the RAV with a total exposure time of 6.45 min. AVS: adrenal vein sampling; LAV: left adrenal vein; RAV: right adrenal vein; LRV: left renal vein; IVC: inferior vena cava; IEV: inferior emissary vein; PV: phrenic vein.

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