Parathyroid Angiography: A Review of Current Knowledge and Guidelines for Clinical Application*

IN THE YEARS since the first localization (1) and visualization (2) of parathyroid lesions by arteriography, there has accumulated a large body of knowledge about the anatomical basis of parathyroid angiography, the proper and safe application of these techniques, and the subtilities of their interpretation. This information is now widely scattered in the radiographic, surgical, and internal medicine literature. This review is undertaken to provide the internist with a concise summary of this knowledge, in order to facilitate the optimum application of these techniques. We will review the pertinent facts about parathyroid embryology, vascular anatomy, and blood flow patterns. We will outline the goals, risks and interpretation of arteriography and venous sampling. Tentative guidelines are presented to aid in the selection of patients who are most likely to benefit from these techniques. Arterial Anatomy and Embryology Accurate performance and interpretation of parathyroid angiographic studies requires an understanding of regional vascular anatomy and blood flow patterns.