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Updated: Jun 28, 2025

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Utility of Repeat Sampling in Bilateral Aldosterone Suppression During Adrenal Vein Sampling for Primary
Bella Halim1,2, Eric X Z Yong3,4, Matthew Egan5
1Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Victoria 3065, Australia.
Abstract:
Primary aldosteronism (PA) is the most common form of secondary hypertension. Accurate subtyping of PA is essential to identify unilateral disease, as adrenalectomy improves outcomes. Subtyping PA requires adrenal vein sampling (AVS), which is technically challenging and results from AVS may not always be conclusive. We present a case of a 37-year-old man with PA whose AVS studies were inconclusive due to apparent bilateral aldosterone suppression (ABAS). As a result, our patient was misdiagnosed as having bilateral PA and medically managed until a repeat AVS showed lateralization to the right adrenal gland. ABAS is an underrecognized phenomenon that may confound the subtyping of PA. We recommend repeating AVS in such cases and discuss strategies to minimize ABAS.
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