MON-281 Comparison of Fluoroscopy Time and Radiation Exposure in Unilateral vs Bilateral Femoral Vein Access during Adrenal Venous Sampling in Patients with Primary Hyperaldosteronism

Abstract Disclosure: M. Neff: None. J. Lin: None. P. Aghajafari: None. N. Sharma: None. J. Sandhu: None. E. Garcia: None. C. Issa: None. K. Kozlowski: None. E. Hilborn: None. Z. Miller: None. Purpose: Adrenal venous sampling (AVS) is a technically demanding procedure used to diagnose primary aldosteronism and guide treatment in patients with adrenal disorders. Given the procedure’s complexity, minimizing radiation exposure is critical for patient safety. This study compares fluoroscopy time and radiation exposure between bilateral and unilateral femoral vein access during AVS. Materials and Methods: A retrospective review of 61 patients who underwent AVS between 05/2020 and 8/2024 was conducted. Fluoroscopy time (minutes) and radiation dose (mGy) were collected for both unilateral (n=12, 20%) and bilateral (n=49, 80%) femoral vein access techniques. For statistical analysis, normality was assessed using the Shapiro-Wilk test. Nonparametric tests were performed for the comparison analysis. The Wilcoxon signed-rank test demonstrated Z = -1.297 for fluoroscopy time and Z = -1.778 for radiation dose. Results: The median fluoroscopy time for bilateral femoral access was 46.8 minutes (IQR 35.2 - 58.8 minutes), while the median for unilateral femoral access was 64.3 minutes (IQR 36.2 - 79.4 minutes). The median radiation exposure was 351.5 mGy for bilateral femoral access (IQR 173.4 - 762.7 mGy) and 634.9 mGy for unilateral femoral access (IQR 385.4 - 850.6 mGy). Statistical analysis using the Mann-Whitney U test showed no significant difference in fluoroscopy time (p = 0.195) or radiation exposure (p = 0.075) between the two groups. Although the differences were not statistically significant, it is left to the reader’s discretion to determine the clinical relevance of these findings in specific cases. Conclusion: Bilateral femoral vein access during AVS was associated with reductions in both fluoroscopy time and radiation exposure when compared to unilateral femoral vein access, though these differences did not reach statistical significance. Readers may consider these findings when deciding on access technique within the clinical context of the procedure. Presentation: Monday, July 14, 2025