Adrenal venous sampling in primary aldosteronism: lessons from over 600 single-operator procedures

Area of Science:

• Endocrinology
• Interventional Radiology
• Hypertension Management

Background:

• Primary aldosteronism is the most common cause of secondary hypertension.
• Adrenal vein sampling (AVS) is essential for diagnosing primary aldosteronism.
• Successful AVS is operator-dependent and requires specialized expertise.

Purpose of the Study:

• To provide a detailed, single-operator account of over 600 adrenal vein sampling procedures.
• To train future radiologists in performing AVS.
• To guide the establishment of new AVS programs.

Main Methods:

• Review of 20 years of single-operator experience in AVS.
• Detailed description of techniques, including managing variant anatomy and cannulation.
• Emphasis on collaboration with endocrinology and clinical chemistry for quality control.

Main Results:

• Successful AVS is achievable with meticulous technique and anatomical knowledge.
• Continuous quality control through multidisciplinary collaboration is vital.
• The described methods facilitate successful AVS program development.

Conclusions:

• Adrenal vein sampling is a critical diagnostic tool for primary aldosteronism.
• This detailed experience offers a valuable training resource for AVS.
• Successful AVS programs can lead to the cure of resistant hypertension.