Techniques of adrenal venous sampling in patients with inferior vena cava or renal vein anomalies.

Objective: To review the techniques and technical success rate of adrenal venous sampling (AVS) in patients with inferior vena cava (IVC) or renal vein anomalies.

Methods: The techniques and success rate of AVS in 15 patients with anomalies [8 with double IVC (dIVC), 3 with left IVC (ltIVC), 2 with retroaortic left renal vein (LRV), and 2 with circumaortic LRV] underwent AVS was retrospectively reviewed.

Results: Among 11 patients with IVC anomalies, the success rates for sampling the right and left adrenal veins (RAV and LAV) were 81.8 and 90.9%, respectively. In dIVC, the LAV was selected using the following four methods: approaching through the right IVC from the right femoral vein, flipping the LAV catheter tip in the LRV (n = 4) or the interiliac-communicating vein (n = 1), or through the ltIVC from the right (n = 1) or left (n = 2) femoral vein. Among the four patients with LRV anomalies, the success rate was 100% for each adrenal vein.

Conclusions: AVS can be successfully performed in patients with anomalies. The key to technical success is understanding the venous anatomy based on pre-procedural CT images and choosing appropriate methods.