SIR 2024
Venous Interventions
Konrad Kozlowski, MS3
Medical Student
University of Miami Miller School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Chloe E. Issa, B.S.
University of Miami Medical Student
University of Miami
Financial relationships: Full list of relationships is listed on the CME information page.
Anmol Patel, MS-4
Medical Student
University of Miami Miller School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Jack Lin, B.A.
University of Miami Medical Student
University of Miami
Financial relationships: Full list of relationships is listed on the CME information page.
John O. Lew, MD
Professor of Clinical Surgery, Chief, Division of Endocrine Surgery, Fellowship Director Endo Surg
University of Miami Miller School of Medicine
Disclosure information not submitted.
Following IRB approval, an electronic survey was distributed to active members of the American Association of Endocrine Surgeons (AAES). Data collected included demographics, practice type, referral patterns, opinions on PA management, utilization of AVS, confidence levels in AVS and IR proceduralists and satisfaction with AVS results.
Results: Of 89 completed responses from the AAES, 83 (93%) were ES with the remainder not fellowship trained in Comprehensive Endocrine Surgery. Of all respondents, 52% (n=46) had 10+ years of practice experience, and 61% (n=62) were at academic centers. Specialists managed 7.75 (±5.69) PA patients per year. Among these surgeons, 70% reported “always” ordering AVS for PA, while 29% stated they “sometimes” ordered AVS. If bilateral adrenal nodules were identified on imaging, 100% of surgeons referred patients for AVS, whereas 77% referred patients with unilateral nodules. Among this group, 55% reported they trusted their IR physician of choice to perform AVS whereas another 30% replied they trusted the associated IR group. AAES respondents “always” referred patients for AVS to local academic centers (76%), and “never” referred patients to local private IR groups (77%) or distant academic centers (76%). Of the entire group, 82% of respondents were satisfied with AVS results when performed.
Conclusion: AVS is an indispensable imaging adjunct in the surgical management of PA, a prevailing sentiment amongst AAES members. Referral patterns and opinions indicate a preference for sending patients to specific IR physicians at local academic centers. Communication with referring ES, integration of AVS technique into simulated and live training curricula and development of guidelines for performance and reporting of AVS may improve collaboration with both academic and private interventional radiologists who perform such procedures.