In all cases the right femoral vein was punctured first and a SIM 1 (4 F) (Cordis), Cobra (4-5 F; Cordis), or Shepherd Hook (4-5 F; Angiodynamics) catheters were used to localize and draw blood from the right
adrenal vein. Next, a SIM 2 (Cordis), or SIM 3 (4 F; Cordis) catheter was used to localize and draw blood from the left
adrenal vein.
(17) After successful catheterization of both
adrenal veins under interventional radiology, comparison of the aldosterone to cortisol ratio between both sides is the currently accepted criterion for determining unilateral versus bilateral disease.
Identification of the etiology of primary aldosteronism with
adrenal vein sampling in patients with equivocal computed tomography and magnetic resonance findings: results in 104 consecutive cases.
cruzi and parasitemia in the central
adrenal vein has been correlated with the development of chronic chagasic cardiomyopathy [58, 59].
Selective
adrenal vein sampling is infrequently performed.
Cathecolamines (epinephrine and norepinephrine) and more than thirty biologically active peptides (neuropeptide Y, dopamine, chromogranins A, B, C, methionine, calcitonin gene-related peptide, leucine, enkephalin, substance P, synaptophysine, endotelins, adrenomedullin, interleukin-1) are stored in coated granules within the chromaffin cells and are delivered through cellular depolarization and exocytosis via
adrenal vein into the circulating blood (Colomer 2009).
(31,32) Large adrenal carcinomas tend to invade the
adrenal vein and inferior vena cava.
If there is an adrenal mass,
adrenal vein sampling (AVS) should be tested.
The entire specimen was removed en bloc (Figure 2) consisting of diaphragm, right adrenal metastasis measuring 6 cm x 4 cm x 3 cm, a scant amount of normal adrenal tissue, the small patch of IVC and the right
adrenal vein which was completely encased by tumor.
Following ACTH stimulation the mean
adrenal vein vitamin C level increased approximately four fold, and then subsequently returned to near pre-stimulation levels approximately 15 minutes thereafter.
It is estimated that only four to six people are diagnosed with this type of tumour in Scotland each year and in Allison's case it had already started to spread to her
adrenal vein. With a fear of hospitals and surgery, Allison was terrified of going under the knife to have her four centimetre-long adrenal gland tumour cut out.
Complications occurred in five patients (5%) including one postoperative ileus, one superficial wound infection, one postoperative incisional neuropathy, one bleeding from the left renal artery, and one bleeding from the
adrenal vein.
