MON-282 Referral Patterns and Perceptions of Interventional Radiologists in Adrenal Vein Sampling (AVS): A Survey of the American Association of Endocrine Surgeons

Abstract Disclosure: M. Neff: None. K. Kozlowski: None. J. Lin: None. C. Issa: None. A. Patel: None. H. Clode: None. T. Pennix: None. T. Vaghaiwalla: None. J.I. Lew: None. Z. Miller: None. Introduction: Adrenal venous sampling (AVS), performed by interventional radiologists, is the standard method for lateralizing unilateral adrenal tumors in Primary Hyperaldosteronism (PA). Endocrine Surgeons (ES) utilize unilateral tumor lateralization by AVS results pre-operatively to guide adrenalectomy for successful surgical PA treatment. This study explores the referral patterns of Endocrine Surgeons (ES) and the necessity for AVS performed by interventional radiology (IR) in patients with PA. Methods: After IRB approval, an electronic survey was distributed to active members of the American Association of Endocrine Surgeons (AAES). The survey collected data regarding demographics, practice type, referral patterns, opinions on PA management, AVS utilization, confidence levels in AVS and IR proceduralists and satisfaction with AVS outcomes. Results: Of 107 completed responses from the AAES, 100 (93.5%) were ES with the remainder not fellowship trained in Comprehensive Endocrine Surgery. Among all respondents, 45% (n=48) had 10+ years of practice experience. The most common practice size was 3-5 surgeons (43%, n=45), and 61% (n=74) were based at academic centers. Specialists managed 7.54 (±5.71) PA patients per year. Among these surgeons, 71% reported “always” ordering AVS for PA, while 28% stated they “sometimes” ordered AVS. If bilateral adrenal nodules were identified on imaging, 100% of surgeons referred patients for AVS, whereas 78% referred patients with unilateral nodules. Among this group, 56% reported they trusted their IR physician of choice to perform AVS whereas another 31% replied they trusted the associated IR group. AAES respondents “always” referred patients for AVS to local academic centers (71%), and “never” referred patients to local private IR groups (75%) or distant academic centers (75%). Of the entire group, 83% of respondents were satisfied with AVS results when performed, and 100% felt that AVS is helpful in the management of patients with PA. Conclusion: AVS is considered an indispensable imaging tool in the surgical management of PA, a view widely shared amongst AAES members. Referral patterns and feedback suggest a preference for sending patients to specific IR physicians at local academic centers. Enhancing communication with referring ES, incorporating AVS technique into both simulated and live training curricula, and developing guidelines for AVS performance and reporting may strengthen collaboration between academic and private interventional radiologists who perform these procedures. Presentation: Monday, July 14, 2025