When is adrenal venous sampling indicated in the workup of primary aldosteronism?

Updated: Mar 24, 2020
  • Author: Gabriel I Uwaifo, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Because this procedure is highly dependent on the availability of technically proficient interventional radiologists, it cannot (and should not) be performed universally, despite the fact that it is the criterion standard for the confirmation of lateralizable aldosterone excess. [34, 35, 36] Indeed, adrenal venous sampling may be performed selectively only when preoperative imaging cannot definitively lateralize a presumed unilateral aldosteronoma. A report by Dekkers et al supports this line of argument and challenges the notion of performing adrenal venous sampling in all patients with primary aldosteronism. The study found that at 1-year follow-up, intensity of hypertensive medication and clinical benefits did not significantly differ between patients assessed by adrenal venous sampling and those evaluated by adrenal CT scan. [37]


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