A preliminary study of C-arm CT-assisted Adrenal Vein Sampling in Primary Aldosteronism

Aim Evaluate the success rate and accuracy of C-arm CT technology in adrenal venous sampling, and analyze the impact of C-arm CT technology on patient radiation dose. Methods The researchers collected demographic data, adrenal venous sampling results, preoperative CT scans, and surgical imaging related to adrenal venous sampling from patients that diagnosed with PA at Beijing Anzhen Nanchong Hospital of Capital Medical University&Nanchong Central Hospital between February 2020 and June 2024. Based on whether C-arm CT was used to assist with the procedure, the patients were divided into Group A and Group B. The researchers analyzed and recorded various indicators, including the blood sampling success rate, accuracy, intraoperative radiation dose, surgical operation time, intraoperative radiation time,contrast agent usage, and adverse reactions related to adrenal venous sampling for both groups. Results The study found that it was without a significant statistical difference in the demographic data between two group, including sex, age, BMI,blood pressure, ALD, renin and ARR in primary screening test. In the right side, the success rates of AVS were 60% in Group A vs 90.91% in Group B, P < 0.05. While the success rates of AVS in the left side were 85% in Group A vs 96.97% in Group B, P > 0.05. The conventional AVS identified 8 patients (40%) with unilateral forms of PA and 12 patients (60%) with bilateral PA. With C-arm CT, the proportion of bilateral PA tended to increase (69.7%), P < 0.05. The study found that The total radiation dose was 427.230 ± 94.330 mGy in Group A vs 340.852 ± 96.218 mGy in Group B, P = 0.002. The total dose of contrast media was 49.350 ± 8.349ml in Group A vs 37.576 ± 7.579ml in Group B, P < 0.001. The radiation time was 22.134 ± 8.869 minutes in Group A vs 12.466 ± 6.180 minutes in Group B, P < 0.001. Conclusion In summary, the use of C-arm CT technology to guide adrenal venous sampling significantly improves the success rate of AVS while also reducing the radiation dose, exposure time, and contrast agent volume for both patients and operators. This approach is worth promoting.