Adrenal venous sampling in primary aldosteronism: Experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register)

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Adrenal venous sampling in primary aldosteronism: Experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register)

Publicated to:ENDOCRINE. 78 (2): 363-372 - 2022-06-25 78(2), DOI: 10.1007/s12020-022-03122-8

Authors: Araujo-Castro, Marta; Paja Fano, Miguel; Gonzalez Boillos, Marga; Pla Peris, Begona; Pascual-Corrales, Eider; Garcia Cano, Ana Maria; Parra Ramirez, Paola; Rojas-Marcos, Patricia Martin; Ruiz-Sanchez, Jorge Gabriel; Vicente Delgado, Almudena; Gomez Hoyos, Emilia; Ferreira, Rui; Garcia Sanz, Inigo; Recasens Sala, Monica; Barahona San Millan, Rebeca; Picon Cesar, Maria Jose; Diaz Guardiola, Patricia; Garcia Gonzalez, Juan Jesus; Perdomo, Carolina M; Manjon Miguelez, Laura; Garcia Centeno, Rogelio; Percovich, Juan Carlos; Rebollo Roman, Angel; Gracia Gimeno, Paola; Robles Lazaro, Cristina; Morales-Ruiz, Manuel; Hanzu, Felicia A

Affiliations

CIBEROBN, Madrid, Spain - Author

Clin Univ Navarra, Endocrinol & Nutr Dept, Pamplona, Spain - Author

Complejo Univ Salamanca, Endocrinol & Nutr Dept, Salamanca, Spain - Author

Hosp Clin Barcelona, Biochem & Mol Genet Dept CDB, IDIBAPS, CIBERehd, Barcelona, Spain - Author

Hosp Clin Barcelona, Endocrinol & Nutr Dept, Barcelona, Spain - Author

Hosp Reina Sofia, Endocrinol & Nutr Dept, Cordoba, Cordoba, Spain - Author

Hosp Rollo Villanueva, Endocrinol & Nutr Dept, Zaragoza, Spain - Author

Hosp Univ Basurto, Endocrinol & Nutr Dept, OSI Bilbao Basurto, Bilbao, Spain - Author

Hosp Univ Castellon, Endocrinol & Nutr Dept, Castellon de La Plana, Spain - Author

Hosp Univ Cent Asturias, Endocrinol & Nutr Dept, Oviedo, Spain - Author

Hosp Univ Fdn Jimenez Diaz, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ Gregorio Maranon, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ Infanta Sofia, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ La Paz Madrid, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ Princesa, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ Princesa, Gen & Digest Surg Dept, Madrid, Spain - Author

Hosp Univ Ramon & Cajal, Biochem Dept, Madrid, Spain - Author

Hosp Univ Ramon & Cajal, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ Toledo, Endocrinol & Nutr Dept, Toledo, Spain - Author

Hosp Univ Valladolid, Endocrinol & Nutr Dept, Valladolid, Spain - Author

Hosp Univ Virgen Macarena, Endocrinol & Nutr Dept, Seville, Spain - Author

Hosp Univ Virgen Victoria Malaga, Endocrinol & Nutr Dept, IBIMA, Malaga, Spain - Author

Inst Catala Salut Girona, Endocrinol & Nutr Dept, Girona, Spain - Author

Inst Invest Sanitaria Principado Asturias ISPA, Oviedo, Spain - Author

Instituto Invest Biomed Ramon & Cajal IRYCIS, Madrid, Spain - Author

Univ Alcala, Madrid, Spain - Author

Univ Basque Country, Med Dept, Bilbao, Spain - Author

Abstract

Objective The aim of this study was to evaluate the rate of adrenal venous sampling (AVS) performance in patients with primary aldosteronism (PA), the main reasons for its non-performance, and the success and complications rate of this procedure in Spain. Moreover, the concordance between CT/MRI and AVS for PA subtyping was evaluated. Methods A retrospective multicenter study of PA patient follow-up in 20 Spanish tertiary hospitals between 2018-2021 was performed (SPAIN-ALDO Register). Results Of the 440 patients with PA included in the study, 153 underwent AVS (34.8%). The main reasons for not performing AVS were: patient rejection to the procedure, low catheterization rate in the center and unilateral disease based on CT/MRI. The overall success rate was 44.4% (the left adrenal vein was properly canulated in 77.8% and the right adrenal vein in 48.4%). Only 3 patients experienced minor complications. In the 45 patients with unilateral disease according to AVS, CT/MRI indicated bilateral disease or normal adrenal glands in 17. In the 23 patients with bilateral disease, CT/MRI indicated unilateral disease in 14. However, no significant differences were observed in biochemical response (P = 0.051) and hypertension resolution (P = 0.150) between patients who underwent surgery based on CT/MRI results and those who underwent surgery based on AVS results. Conclusion In our setting, AVS is still an underused technique in patients with PA. The low experience and success rate in AVS partially justify these results. More training for providers and patients needs to be done to include appropriate well performed AVS in the diagnosis algorithm of PA.

Keywords

Adrenal venous samplingAdrenalectomAdrenalectomyCConsensusDiagnosisEndocrineLateralization indexOutcomesPrimary aldosteronismScanSelectivity indexSocietyStatementTomography

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Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal ENDOCRINE due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Endocrinology, Diabetes and Metabolism. Notably, the journal is positioned en el Cuartil Q3 for the agency WoS (JCR) in the category Endocrinology & Metabolism.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 4.69. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

Weighted Average of Normalized Impact by the Scopus agency: 4 (source consulted: FECYT Feb 2024)
Field Citation Ratio (FCR) from Dimensions: 11.75 (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-15, the following number of citations:

WoS: 19
Scopus: 20
OpenCitations: 18

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