title: Does catheter shape influence the success of right adrenal venous sampling? The interaction of catheter shape to anatomical factors on CT.
abstract: OBJECTIVE
  To evaluate the importance of selecting an appropriate catheter shape for the right adrenal vein (RAV) anatomy on CT to the success of right adrenal venous sampling (RAVS) by elucidating the interactions of anatomical factors with catheter shape.
  
  
  METHODS
  130 patients with enhanced CT underwent RAVS using two catheters: catheter 1 was planar and catheter 2 was a three-dimensional shape. The following anatomical factors on CT were evaluated in each patient: presence of a right adrenal tumor, presence of a common trunk with an accessory right hepatic vein, diameter of the RAV, short and long diameters of the IVC, ratio of the long to the short diameter of IVC, and the transverse, modified transverse, and vertical angles of the RAV. RAVs were classified by direction on CT as lateral-caudal, lateral-cranial, medial-caudal, or medial-cranial. The technical feasibility of each catheter was evaluated by intragroup analysis.
  
  
  RESULTS
  108 patients underwent technically successful RAVS with one or both catheters. Eight of the 22 patients in whom RAVS was not successfully achieved by either catheter within ten minutes required microcatheters; other catheters were used in the other 14. The factors that were found to be associated with RAVS success were the modified transverse and the vertical angles (p < 0.01) of RAV on CT. Catheters 1 and 2 provided stable sampling in the lateral-caudal and medial groups, respectively.
  
  
  CONCLUSIONS
  Adapting the shape of the catheter to the anatomy of the RAV can make RAVS more feasible. The anatomical factors that were found to be associated with RAVS success were the transverse angle modified by the IVC axis as well as the vertical angle of RAV on CT.
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3898, Japan. taraki@yamanashi.ac.jp.
authors.forename: Takuji
authors.initials: T
authors.lastname: Araki
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
mesh_terms: D000311:Adrenal Glands / Q000098:blood supply*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D003287:Contrast Media; D004867:Equipment Design; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D006929:Hyperaldosteronism / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011446:Prospective Studies; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014680:Veins; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media
keywords: CT; Right adrenal vein anatomy; Right adrenal venous sampling; Sampling catheter