- 期刊
- OpenAccess
Low-Grade Pain as a Useful Indicator of Successful Cannulation of Right Adrenal Vein
摘要
PURPOSE. Adrenal venous sampling (AVS) is technically challenging because it involves sampling the right adrenal vein (RAV). In our experience, RAV manipulation is often accompanied by mild right chest or flank pain. We assessed the value of low-grade pain as an indicator of successful cannulation of the RAV. MATERIALS AND METHOD. Between July 2018 and June 2019, we prospectively enrolled 63 patients with primary aldosteronism (PA) who underwent nonstimulated AVS at our hospital. A numerical rating scale was used to evaluate pain (range = 0-10) upon contrast media injection into the RAV, accessory hepatic vein, right capsular vein, left adrenal vein (LAV), and right femoral vein. RESULTS. The success rate of AVS was 100% (63/63), based on a selectivity index of ≥ 2 for both adrenal veins. The pain scores for the RAV, LAV, confounding veins (n = 30; 26 accessory hepatic and 4 right capsular veins), and peripheral vein were 1.8 ± 1.9, 0.1 ± 0.4, 0.1 ± 0.4, and 0, respectively. The pain score for the RAV was higher than those of the confounding veins (p = 0.001) and LAV (p < 0.001). Venography with pain information had higher sensitivity and accuracy (p < 0.001 for both) than venography alone in terms of the confirmation of the RAV by two separate readers, with a nonsignificant trend toward higher specificity (p = 0.125 and 0.063 for readers 1 and 2, respectively). CONCLUSION. Low-grade pain is a simple and rapid indicator for identifying the RAV, thereby adding diagnostic value to traditional venography.