"Interoperative" Quick Parathyroid Hormone Assay

甲状旁腺静脉采样仍然是甲状旁腺手术失败患者最精确的定位技术，但它需要血管造影师的丰富经验以及长时间的导管操作来采样引流颈部和纵隔的多条小静脉。了解手术过程中甲状旁腺激素(PTH)梯度的存在将使血管造影师能够专注于特定区域，也许可以获得更详细的样本，并在早期样本出现显著梯度时缩短手术过程。该方案不会增加采样的准确性，但会缩短程序，减少对患者和介入放射科医生的辐射暴露，并通过更有针对性的采样实现更精确的定位。另一个方案94-DK-0195的成功减少了需要甲状旁腺静脉采样的患者数量，因此我们最初对研究频率的估计不再有效。目前，很难积累足够的患者来及时完成这项研究。这项测试在少数OR患者中被证明是有效的，我们不再认为它是一项研究。现在，当需要时，它被用于常规的病人护理。今年没有新的科目招生。我们已经终止了这个协议。

Parathyroid venous sampling remains the most precise localization technique for patients with failed parathyroid surgery but it requires considerable experience on the part of the angiographer as well as prolonged catheter manipulation to sample the multiple small veins draining the neck and mediastinum. Knowledge of the presence of parathyroid hormone (PTH) gradients during the procedure would enable the angiographer to focus on a specific area, perhaps obtaining more detailed samples and to shorten the procedure when significant gradients occur in the early samples. This protocol will not increase the accuracy of sampling but will shorten the procedure, reduce radiation exposure to the patient and to the interventional radiologist and allow more precise localization by more focused sampling. The success of another protocol 94-DK-0195 has decreased the number of patients who need parathyroid venous sampling so our original estimates of the frequency of the study are no longer valid. At the current time, it would be difficult to accrue enough patients to complete this study in a timely fashion. The test has proven effective in the few OR patients accrued and we no longer consider it to be investigational. It is now used in routine patient care when needed. No new subjects were enrolled this year. We have terminated this protocol.