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Related Experiment Video

Updated: May 12, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
06:08

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Published on: September 15, 2017

Adrenal venous sampling: promises and pitfalls.

Barry A Sacks1, Olga R Brook, Ian M Brennan

  • 1Department of Interventional Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. bsacks@bidmc.harvard.edu

Current Opinion in Endocrinology, Diabetes, and Obesity
|April 11, 2013
PubMed
Summary

Adrenal vein sampling (AVS) is crucial for diagnosing primary aldosteronism, but protocols and expertise vary. Improving AVS technique and interpretation is essential for accurate diagnosis and patient management.

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Area of Science:

  • Endocrinology
  • Interventional Radiology

Background:

  • Adrenal vein sampling (AVS) is the gold standard for diagnosing primary aldosteronism.
  • Variability exists in AVS protocols and interpretation criteria across institutions.

Purpose of the Study:

  • To review current indications for AVS.
  • To highlight technical challenges and interpretation strategies.
  • To address the shortage of expert interventional radiologists.

Main Methods:

  • Review of published protocols for AVS performance.
  • Analysis of diagnostic criteria for differentiating aldosterone-producing adenoma and bilateral adrenal hyperplasia.
  • Discussion of techniques to improve AVS success rates.

Main Results:

  • Significant variability in published AVS protocols and diagnostic criteria.
  • Inability to catheterize the right adrenal vein is a primary cause of technical failure.
  • Preplanning CT, intraprocedural cortisol levels, and cone-beam CT aid in right adrenal vein identification.

Conclusions:

  • Increased demand for AVS necessitates more interventional radiologists acquiring expertise.
  • Standardization of AVS protocols, ACTH stimulation, and result interpretation remains unresolved.
  • Despite variability, diverse AVS approaches demonstrate clinical success.