Abstract:
Selective venous sampling (SVS), an invasive radiographic procedure that depends on contrast media, holds a unique role in diagnosing and guiding the treatment of certain types of secondary hypertension, particularly in patients who may be candidates for curative surgery. The adrenal venous sampling (AVS), in particular, is established as the gold standard for localizing and subtyping primary aldosteronism (PA). Throughout decades of clinical practice, AVS could be applied not only to PA but also to other endocrine diseases, such as adrenal Cushing syndrome (ACS) and Pheochromocytomas (PCCs). Notably, the application of AVS in ACS and PCCs remains less recognized compared to PA, with the low success rate of catheterization, the controversy of results interpretation, and the absence of a standardized protocol. Additionally, the AVS procedure necessitates enhancements to boost its success rate, with several helpful but imperfect methods emerging, yet continued exploration remains essential. We also observed renal venous sampling (RVS), an operation akin to AVS in principle, serves as an effective means of diagnosing renin-dependent hypertension, aiding in the identification of precise sources of renin excess and helping the selection of surgical candidates with renin angiotensin aldosterone system (RAAS) abnormal activation. Nonetheless, further basic and clinical research is needed. Selective venous sampling (SVS) can be used in identifying cases of secondary hypertension that are curable by surgical intervention. Adrenal venous sampling (AVS) and aldosterone measurement for classificatory diagnosis of primary aldosteronism (PA) are established worldwide. While its primary application is for PA, AVS also holds the potential for diagnosing other endocrine disorders, including adrenal Cushing\'s syndrome (ACS) and pheochromocytomas (PCCs) through the measurements of cortisol and catecholamine respectively. In addition, renal venous sampling and renin measurement can help to diagnose renovascular hypertension and reninoma.
摘要:
选择性静脉采样(SVS),一种依赖于造影剂的侵入性射线照相程序,在诊断和指导某些类型的继发性高血压的治疗方面具有独特的作用,特别是在可能是治愈性手术候选人的患者中。肾上腺静脉采样(AVS),特别是,被确立为定位和分型原发性醛固酮增多症(PA)的黄金标准。在几十年的临床实践中,AVS不仅可以应用于PA,还可以应用于其他内分泌疾病,如肾上腺库欣综合征(ACS)和嗜铬细胞瘤(PCCs)。值得注意的是,与PA相比,AVS在ACS和PCC中的应用仍然不太受欢迎,置管成功率低,结果解释的争议,以及缺乏标准化的协议。此外,AVS程序需要增强以提高其成功率,随着几种有用但不完美的方法的出现,然而,继续探索仍然至关重要。我们还观察了肾静脉采样(RVS),原则上类似于AVS的操作,作为诊断肾素依赖性高血压的有效手段,帮助确定肾素过量的精确来源,并帮助选择肾素血管紧张素醛固酮系统(RAAS)异常激活的手术候选人。尽管如此,需要进一步的基础和临床研究。选择性静脉采样(SVS)可用于识别可通过手术干预治愈的继发性高血压病例。肾上腺静脉采样(AVS)和醛固酮测量用于原发性醛固酮增多症(PA)的分类诊断已在世界范围内建立。虽然它的主要应用是PA,AVS还具有诊断其他内分泌紊乱的潜力,包括肾上腺库欣综合征(ACS)和嗜铬细胞瘤(PCCs),分别通过测量皮质醇和儿茶酚胺。此外,肾静脉采样和肾素测量有助于诊断肾血管性高血压和肾癌。