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Adrenal vein sampling: technique and protocol, a systematic review.

Keith B Quencer1

  • 1Department of Radiology, Division of Interventional Radiology, University of Utah, 50 North Medical Drive, Salt Lake City, UT, 84132, USA. keith.quencer@hsc.utah.edu.

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Summary

Primary aldosteronism causes secondary hypertension; adrenal vein sampling distinguishes unilateral from bilateral aldosterone production. This review details techniques to improve sampling success for better patient outcomes.

Keywords:
Adrenal vein samplingAldosterone producing adenomaCosyntropinPrimary aldosteronism

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Area of Science:

  • Endocrinology
  • Nephrology
  • Surgical Innovation

Background:

  • Primary aldosteronism is the primary cause of secondary hypertension globally.
  • Its health impacts exceed those of hypertension alone.
  • Differentiating unilateral from bilateral aldosterone production is crucial for treatment decisions.

Purpose of the Study:

  • To review techniques for enhancing adrenal vein sampling success.
  • To provide background, rationale, and evidence for selecting procedural and interpretation protocols.
  • To guide clinicians in optimizing the diagnosis of primary aldosteronism.

Main Methods:

  • Review of existing adrenal vein sampling protocols.
  • Discussion of techniques to improve cannulation success.
  • Analysis of factors influencing procedural success and interpretation.

Main Results:

  • Adrenal vein sampling is the gold standard for lateralizing aldosterone production.
  • Procedural success rates can be significantly improved with specific techniques and expertise.
  • Multiple protocols exist, each with unique advantages and limitations.

Conclusions:

  • Optimizing adrenal vein sampling is key to identifying patients who can benefit from curative surgery.
  • Knowledge of various protocols and technical nuances improves diagnostic accuracy.
  • This review offers a guide for selecting appropriate protocols to enhance procedural success in diagnosing primary aldosteronism.