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Master Thesis

Influence des critères diagnostiques sur l'interprétation du cathétérisme des veines surrénales dans l'hyperaldostéronisme primaire

Abstract : Guidelines promote the use of adrenal vein sampling (AVS) to document lateralized aldosterone hypersecretion in primary aldosteronism. However, there are large discrepancies between institutions in the criteria used to interpret its results. Our objective was to evaluate the consequences of these differences on the classification and management of patients. The results of all 537 AVS performed between 01/2001 and 06/2010 in our institution were interpreted with four diagnostic criteria used in experienced institutions where AVS is performed without cosyntropin (Brisbane, Padua, Paris, and Turin). AVS were classified as unsuccessful, lateralized, or not lateralized according to each set of criteria. AVS were classified as unsuccessful with the strictest criteria in 18% of cases versus 4% with the least strict criteria. With the least stringent criteria, 60% of AVS were classified as lateralized, versus 26% with the most stringent criteria. Multiple samples were available from at least one side for 155 AVS. These procedures were classified differently by at least two right-left sample pairs in 12% to 20% of cases. Thus, different sets of criteria used to interpret AVS in experienced institutions translate into extremely heterogeneous classifications, and hence management decisions, for patients with primary aldosteronism. AVS cannot be regarded as a gold standard until the most appropriate procedure and diagnostic criteria have been defined.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01150910
Contributor : Université Paris Descartes - Scd <>
Submitted on : Tuesday, May 12, 2015 - 10:57:12 AM
Last modification on : Friday, October 23, 2020 - 4:42:48 PM
Long-term archiving on: : Monday, September 14, 2015 - 10:57:11 PM

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  • HAL Id : dumas-01150910, version 1

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Gaëlle Lethielleux. Influence des critères diagnostiques sur l'interprétation du cathétérisme des veines surrénales dans l'hyperaldostéronisme primaire. Médecine humaine et pathologie. 2015. ⟨dumas-01150910⟩

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