Adrenal Venous Sampling: Practical Insights and Case Studies

Abstract

Adrenal venous sampling is the procedural standard for identifying patients with primary hyperaldosteronism who may benefit from adrenalectomy. Patients with unilateral aldosterone excess are considered surgical candidates, often referred to as having surgically remediable aldosteronism. Those with bilateral aldosterone excess are typically treated with mineralocorticoid receptor agonists. In this article, the authors present 3 interesting cases that underscore the importance of data analysis. Additionally, they emphasize that primary aldosteronism represents a spectrum of aldosterone production, highlighting the fundamental need for long-term follow-up due to the significant variability in patient responses to treatment.

Keywords: ACTH; Adrenal venous sampling (AVS); Aldosterone to cortisol ratio; Cosyntropin; Lateralization index; Primary hyperaldosteronism (PA); Selectivity index.