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Adrenal Vein Sampling

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Diagnosis and Management of Endocrine Disorders in Interventional Radiology

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Abstract

Primary aldosteronism (PA) is the most common cause of secondary hypertension. Subtypes of PA include unilateral aldosterone-producing adenoma (APA), unilateral adrenal hyperplasia, unilateral multiple adrenocortical nodules, bilateral APAs, and bilateral adrenal hyperplasia. Once PA is diagnosed, distinguishing unilateral APA or unilateral adrenal hyperplasia from other subtypes is of paramount importance because only patients with the unilateral disease are amenable to surgery. Computed tomography (CT) is recommended as an initial imaging tool for the evaluation of adrenal glands. However, due to the small size of APAs and incidental nonfunctioning nodules, CT cannot accurately differentiate PA subtypes in many cases. Adrenal vein sampling (AVS) is the gold standard and the only reliable technique for identifying patients with a surgically curable subtype of PA. AVS is relatively invasive and requires considerable skill, experience, and knowledge. In this chapter, primary aldosteronism, techniques of AVS, anatomic considerations, and potential complications are discussed, and the current state of the literature is reviewed.

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  1. Division of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    Hyeon Yu & Clayton W. Commander

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  2. Clayton W. Commander
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  1. Division of Vascular and Interventional RadiologyDepartment of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    Hyeon Yu

  2. Division of Vascular and Interventional RadiologyDepartment of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    Charles T. Burke

  3. Division of Vascular and Interventional RadiologyDepartment of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    Clayton W. Commander

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Yu, H., Commander, C.W. (2022). Adrenal Vein Sampling. In: Yu, H., Burke, C.T., Commander, C.W. (eds) Diagnosis and Management of Endocrine Disorders in Interventional Radiology. Springer, Cham. https://doi.org/10.1007/978-3-030-87189-5_6

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