Review article

https://doi.org/10.11613/BM.2016.047

Abnormal gel flotation caused by contrast media during adrenal vein sampling

Gabriel Lima-Oliveira orcid.org/0000-0002-5937-9137 ; Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Italy
Giuseppe Lippi ; Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
Gian Luca Salvagno ; Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Italy
Matteo Gelati ; Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Italy
Antonella Bassi ; Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Italy
Alberto Contro ; Vascular Interventional Radiology Unit, Institute of Radiology, University of Verona, Italy
Francesca Pizzolo ; Division of Internal Medicine, Department of Medicine, University of Verona, Italy
Gian Cesare Guidi ; Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Italy

Abstract

Introduction: During adrenal venous sampling (AVS) procedure, radiologists administer a contrast agent via the catheter to visualize the proper catheter position.
Materials and methods: A patient with primary aldosteronism diagnostic-hypothesis was admitted for AVS. A venogram was performed to
confirm the catheter’s position with 2mL of Iopamidol 300 mg/mL. Samples were collected with syringe connected to a hydrophilic coated catheter by low-pressure aspiration from each of the four collection sites: inferior vena cava in the suprarenal portion, inferior vena cava in the infrarenal portion, left adrenal vein, and right adrenal vein; then immediately transferred from syringe to tubes with gel separator. All tubes were centrifuged at 1200 x g for 10 minutes.
Results: At the end of centrifugation process, primary blood tubes containing blood from inferior vena cava and left adrenal vein exhibited the standard gel separator barrier, while tubes from right adrenal vein showed abnormal flotation of gel separator. The radiologist confirmed the usage of 2.6 mL instead of 2.0 mL of Iopamidol 300 mg/mL. This iodinated contrast media, with 1.33 g/cm3 of density, was used close to the right adrenal vein due to some difficulty to access it.
Conclusion: The abnormal flotation of gel separator in samples taken from right adrenal vein can be explained by the usage of the iodinated
contrast media. We suggest using plain-tubes (without gel separator) for AVS in order to avoid preanalytical nonconformities. Moreover, a blood volume equivalent to twice the catheter extension should be discarded to eliminate residual contrast media before collection of samples for laboratory assays.

Keywords

preanalytical phase; blood specimen collection; contrast media; gels; phlebotomy

Hrčak ID:

167752

URI

https://hrcak.srce.hr/167752

Publication date:

15.10.2016.

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