Clinical impact of strict criteria for selectivity and lateralization in adrenal vein sampling

INTRODUCTION: Selectivity index (SI) and lateralization index (LI) thresholds determine the adequacy of adrenal vein sampling (AVS) and the degree of lateralization. The purpose of this study was investigate the clinical outcome of patients whose adrenal vein sampling was interpreted using “strict criteria” (SC) (SI pre-stimuli ≥3, SI post-stimuli ≥5 and LI pre-stimuli ≥4, LI post-stimuli ≥4). MATERIALS AND METHODS: A retrospective review of 73 consecutive AVS procedures was performed and 67 were technically successful. Forty-three patients showed lateralization and underwent surgery, while 24 did not lateralize and were managed conservatively. Systolic blood pressure (SBP), diastolic blood pressure (DBP), kalemia (K + ), and the change in number of blood pressure (BP) medications were recorded for each patient before and after AVS and potential surgery were performed. RESULTS: In the surgery group, BP and K + changed respectively from 160±5.3/100±2.0 mmHg to 127±3.3/80±1.9 (p