I’m in the midst of scheduling a consultation with the interventional radiologist who will be doing my AVS. I’ve been reading tons of abstracts that make me certain that having this procedure first, rather than skipping straight to the surgery, is the way to go.
However. I’m going into it as fully educated as I can be, so I’m constantly on the lookout for more information. I thought this merited sharing here – a PDF of a consent form for the procedure from another hospital (not the one where I will be having it done), most notably, the risks:
Risks associated with the procedure include, but are not
limited to, pain or discomfort at the catheter insertion
site, bleeding at the site, injury to a blood vessel,
infection which may result in an infection of the blood
stream, the development of a blood clot (embolization),
and stroke. Risks associated with the x-ray contrast
material include an allergic reaction and reduced kidney
function. The medications used for the moderate
sedation are associated with the risks of aspiration
(inhaling food or liquid into your lungs) or respiratory
depression. In addition to these potential risks
associated with the procedure, the x-ray contrast
material, and the moderate sedation medications, there may be other unpredictable risks including death.
Hmmm yeah. I guess they’re legally bound to throw that “death” bit in there.
Also of interest was the description of the procedure:
An adrenal venogram involves the placement of a
plastic tube (catheter) into a vein in your leg near the
hip. Some numbing medicine will be injected in the
skin over the vein that will be used before the
catheter is inserted. Intravenous medications may
also be given to you to make you more comfortable
and relaxed. This is known as moderate sedation.
Once the catheter has been placed into the vein, it
will be advanced through the blood vessels. During
this time, x-ray contrast material (x-ray dye) will be
injected through the catheter and x-ray pictures
taken. You may be asked to hold your breath for
several seconds as these pictures are taken. During
the injection of x-ray contrast material, you may
experience a warm feeling or a strange taste in your
mouth. Both of these sensations are temporary and
will go away soon. After localizing the adrenal
veins with the venogram, blood will be drawn
through the tube and sent for laboratory studies. The
laboratory studies take a week or more and the
results will not be available today. At the
completion of the venogram and blood sampling, the
catheter will be removed and pressure will be
applied to the insertion site until the bleeding has
stopped. To help prevent bleeding, it will be very
important for you to lie flat in bed without moving
your leg for two hours.
You know, I’m almost more worried about the “lie flat in bed without moving your leg for two hours” bit than the rest of it! Stillness was never my area of expertise.
In conclusion, though – it’s not as if I have much choice. This consent form spells that out in no uncertain terms:
There is no alternative to adrenal vein blood sampling.
You may choose not to have the procedure done, and the
cause of the elevated aldosterone in your blood will not