1. Introduction
fits, confusion, hypokalemia
CLINICAL SYNDROME, HYPERTENSION, PRIMARY ALDOSTERONISM
Primary aldosteronism (PA) is a clinical syndrome characterized by high aldosterone, low renin activity, hypertension, and hypokalemia [The high success rate of AVS has contributed to the development of unilateral adrenalectomy. Many studies have attempted to accomplish AVS through different vascular accesses, catheters, and devices.When performing AVS, the catheter is superselectively embedded into the bilateral adrenal veins to obtain blood, and even when blood is obtained near the adrenal veins, the blood specimen will still be diluted, affecting the accuracy. Commonly selected sites for blood sampling are the elbow vein and the femoral vein [Due to the different venous opening locations and imaging patterns, as well as the confusion of small branches of the surrounding hepatic veins, the success rate of the right adrenal gland is only about 80% [In the past, researchers tried to improve the success rate of AVS and avoid adrenal vein hemodilution. Some studies proposed effective methods [To address the misclassification from asynchronous AVS of the right and left adrenal glands, some centers use continuous ACTH stimulation; however, ACTH stimulation may reverse the results of the lateralized side [This study is a single-center prospective study that showed an increased success rate of right-sided cannulation to 95%. The study found that the choice of catheter depended on the axial position of the central RAV. For example, when the RAV opening was in quadrant I, an MPA catheter may be the most appropriate. When the RAV opening was in quadrant III, the MPA catheter became difficult to detect. Using a catheter that fits the direction of the adrenal vein opening improved the success rate of AVS. The multipath method expanded catheter selection.In addition, we used multipath AVS through the cubital vein and femoral vein to successfully complete simultaneous AVS. A comparison was made with single-path AVS to compare the effectiveness and safety of the new method. AVS is the gold standard for staging the diagnosis of PA, and we hope to obtain more information through the analysis.