Page 31 - HKSEMR2020 Programme book

Poster Presentation (Clinical) Abstracts

Review of a modified adrenal venous sampling (AVS) protocol

for patients with history of allergy and required steroid cover for
iodinated contrast

K. S. Yan, E. Y. F. Lau, A. Y. Lee
Pamela Youde Nethersole Eastern Hospital

Introduction / Background / Objectives: 44 patients were included in this retrospective study. Patient
information was extracted through the Clinical Data Analysis and
Adrenal venous sampling (AVS) is the gold standard for the
determination of the laterality of primary hyperaldosteronism. Reporting System (CDARS) of the Hospital Authority of Hong Kong.
However, steroid given as a premedication for those who require it Statistical Package for the Social Sciences (SPSS) software was
will make biochemical data uninterpretable. Our hospital designed used for statistical analysis.
a modified protocol for this group of patients using dexamethasone
and tetracosactide, and we have been using it since 2008.
Results / Outcomes:
The International consensus for outcomes after adrenalectomy for
Our primary objective was to assess the accuracy and safety of unilateral primary aldosteronism published in 2017 was used to
this modified protocol compared with a non-stimulated protocol determine the outcomes of all surgical cases included in the study.
for identifying the unilateral form of primary hyperaldosteronism For the positive predictive value (PPV) for clinical benefit (partial or
by evaluating the clinical (post-operative blood pressure and anti- complete clinical success), the non-stimulated protocol reached
hypertensives requirement) and biochemical (potassium level and 96.77%, while the modified protocol was 100%. Both groups
post-operative aldosterone-renin ratio [ARR]) responses of these achieved normal potassium levels after surgery. For the available
patients after surgery, as well as any adverse events during and ARR, the PPV for biochemical success for both protocols was
after the procedure.
100%. There were no adverse events in all 33 cases of AVS using
the modified protocol.

Methods:
Patients who underwent AVS in the period from 1/1/2008 to Conclusion:
31/12/2019 in Pamela Youde Nethersole Eastern Hospital (PYNEH) Our modified protocol is a safe, feasible option for patients who
with subsequent unilateral adrenalectomy were reviewed. Totally
have contrast allergy and need to undergo AVS.

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