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Related Experiment Video

Updated: May 13, 2025

A Novel Method: Super-selective Adrenal Venous Sampling

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

Intraprotocol Adrenal Vein Sampling Inconsistencies in Primary Aldosteronism Lateralization.

Livia M Mermejo^1,2, Lili Zhao³, Chaelin Lee¹

¹Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, 1150 W Medical Center Dr, MSRB II, 5570B, Ann Arbor, MI 48109.

|April 15, 2025

Summary

This summary is machine-generated.

Nearly one-third of patients undergoing adrenal vein sampling (AVS) show inconsistent lateralization results within the same protocol. This variability, crucial for primary aldosteronism diagnosis, was higher in baseline samples compared to cosyntropin-stimulated ones.

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Area of Science:

Endocrinology
Radiology
Internal Medicine

Background:

Primary aldosteronism (PA) diagnosis relies on adrenal vein sampling (AVS) to identify lateralization.
Current AVS protocols may have intraprotocol variability affecting lateralization results.
Understanding this variability is key for accurate PA subtyping and surgical candidacy.

Purpose of the Study:

To quantify intraprotocol lateralization inconsistencies during simultaneous AVS.
To compare variability between baseline and cosyntropin-stimulated AVS measurements.

Main Methods:

Retrospective analysis of 402 patients with PA undergoing simultaneous AVS.
Six sample sets (three baseline, three post-cosyntropin stimulation) analyzed.
Lateralization index (LI) of ≥4 defined as lateralized PA; inconsistencies assessed across triplicate samples.

Main Results:

32.1% of patients exhibited at least one lateralization inconsistency.
Inconsistencies were more frequent in baseline (22.1%) than stimulated (13.2%) AVS sets.
Highest variability observed in baseline samples and in the adrenal vein with lower aldosterone output.

Conclusions:

Significant intraprotocol variability exists in AVS lateralization results.
Baseline AVS measurements demonstrate higher inconsistency than cosyntropin-stimulated measurements.
These findings highlight potential challenges in AVS interpretation and the need for protocol optimization.