Adrenal vein sampling in primary aldosteronism: towards a standardised protocol. 2015

Silvia Monticone, and Andrea Viola, and Denis Rossato, and Franco Veglio, and Martin Reincke, and Celso Gomez-Sanchez, and Paolo Mulatero
Department of Medical Sciences, Division of Internal Medicine and Hypertension Unit, University of Torino, Torino, Italy.

Primary aldosteronism comprises subtypes that need different therapeutic strategies. Adrenal vein sampling is recognised by Endocrine Society guidelines as the only reliable way to correctly diagnose the subtype of primary aldosteronism. Unfortunately, despite being the gold-standard procedure, no standardised procedure exists either in terms of performance or interpretation criteria. In this Personal View, we address several questions that clinicians are presented with when considering adrenal vein sampling. For each of these questions we provide responses based on the available evidence, and opinions based on our experience. In particular, we discuss the most appropriate way to prepare the patient, whether adrenal vein sampling can be avoided for some subgroups of patients, the use of ACTH (1-24) during the procedure, the most appropriate criteria for interpretation of adrenal vein cannulation and lateralisation, the use of contralateral suppression, and strategies to improve success rates of adrenal vein sampling in centres with little experience.

UI MeSH Term Description Entries
D002406 Catheterization, Peripheral Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes. Arterial Catheterization, Peripheral,Catheterization, Bronchial,Catheterization, Peripheral Arterial,Catheterization, Peripheral Venous,Peripheral Catheterization,Venous Catheterization, Peripheral,Bronchial Catheterization,PICC Line Catheterization,PICC Line Placement,PICC Placement,Peripheral Arterial Catheterization,Peripheral Venous Catheterization,Peripherally Inserted Central Catheter Line Insertion,Arterial Catheterizations, Peripheral,Bronchial Catheterizations,Catheterization, PICC Line,Catheterizations, Bronchial,Catheterizations, PICC Line,Catheterizations, Peripheral,Catheterizations, Peripheral Arterial,Catheterizations, Peripheral Venous,PICC Line Catheterizations,PICC Line Placements,PICC Placements,Peripheral Arterial Catheterizations,Peripheral Catheterizations,Peripheral Venous Catheterizations,Placement, PICC,Placement, PICC Line,Placements, PICC,Placements, PICC Line,Venous Catheterizations, Peripheral
D002985 Clinical Protocols Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy. Protocols, Clinical,Research Protocols, Clinical,Treatment Protocols,Clinical Protocol,Clinical Research Protocol,Clinical Research Protocols,Protocol, Clinical,Protocol, Clinical Research,Protocols, Clinical Research,Protocols, Treatment,Research Protocol, Clinical,Treatment Protocol
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006929 Hyperaldosteronism A condition caused by the overproduction of ALDOSTERONE. It is characterized by sodium retention and potassium excretion with resultant HYPERTENSION and HYPOKALEMIA. Aldosteronism,Conn Syndrome,Conn's Syndrome,Primary Hyperaldosteronism,Conns Syndrome,Hyperaldosteronism, Primary,Syndrome, Conn,Syndrome, Conn's
D000306 Adrenal Cortex Neoplasms Tumors or cancers of the ADRENAL CORTEX. Adrenocortical Cancer,Cancer of Adrenal Cortex,Adrenal Cortex Cancer,Cancer of the Adrenal Cortex,Neoplasms, Adrenal Cortex,Adrenal Cortex Cancers,Adrenal Cortex Neoplasm,Adrenocortical Cancers,Cancer, Adrenal Cortex,Cancer, Adrenocortical,Cancers, Adrenal Cortex,Cancers, Adrenocortical,Neoplasm, Adrenal Cortex
D000311 Adrenal Glands A pair of glands located at the cranial pole of each of the two KIDNEYS. Each adrenal gland is composed of two distinct endocrine tissues with separate embryonic origins, the ADRENAL CORTEX producing STEROIDS and the ADRENAL MEDULLA producing NEUROTRANSMITTERS. Adrenal Gland,Gland, Adrenal,Glands, Adrenal
D018246 Adrenocortical Adenoma A benign neoplasm of the ADRENAL CORTEX. It is characterized by a well-defined nodular lesion, usually less than 2.5 cm. Most adrenocortical adenomas are nonfunctional. The functional ones are yellow and contain LIPIDS. Depending on the cell type or cortical zone involved, they may produce ALDOSTERONE; HYDROCORTISONE; DEHYDROEPIANDROSTERONE; and/or ANDROSTENEDIONE. Adenoma, Adrenal Cortical,Conn's Disease,Adenoma, Adrenocortical,Conn Adenoma,Conn Disease,Adenoma, Conn,Adenomas, Adrenal Cortical,Adenomas, Adrenocortical,Adenomas, Conn,Adrenal Cortical Adenoma,Adrenal Cortical Adenomas,Adrenocortical Adenomas,Conn Adenomas,Conns Disease,Disease, Conn,Disease, Conn's
D018962 Phlebotomy The techniques used to draw blood from a vein for diagnostic purposes or for treatment of certain blood disorders such as erythrocytosis, hemochromatosis, polycythemia vera, and porphyria cutanea tarda. Venesection,Venipuncture,Venesections,Venipunctures

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