Update in adrenal venous sampling for primary aldosteronism

Curr Opin Endocrinol Diabetes Obes. 2018 Jun;25(3):160-171. doi: 10.1097/MED.0000000000000407.


Purpose of review: Current guidelines recommend adrenal venous sampling (AVS) to identify the surgically curable causes of hyperaldosteronism. In contrast with this recommendation, AVS remains markedly underutilized in clinical practice, which leads to deny curative adrenalectomy, to many patients with primary aldosteronism. The purpose of this review is to challenge the views that AVS is a technically challenging, invasive and risky procedure, which moreover, is difficult to interpret.

Recent findings: Several studies, including a large international survey on how AVS is being performed and used at major referral centres worldwide the AVIS-1 Study - and a randomized clinical trial comparing and AVS and a computed tomography based strategy, will be examined.

Summary: The results of these studies have sound implications for clinical practice in that they allow to define what to do and what not to do for proper performance and interpretation of AVS and avoidance of the main concern, for example the risk of adrenal vein rupture.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Glands / blood supply*
  • Adrenalectomy
  • Aldosterone
  • Blood Specimen Collection / adverse effects
  • Blood Specimen Collection / methods
  • Female
  • Humans
  • Hyperaldosteronism / blood*
  • Hyperaldosteronism / surgery
  • Male
  • Middle Aged
  • Rupture
  • Tomography, X-Ray Computed
  • Veins* / injuries


  • Aldosterone