• 31 MAR 14

    An expert consensus statement on use of adrenal veinsampling for the subtyping of primary aldosteronism.

    Abstract

    Adrenal venous sampling  is recommended by current guidelines to identify surgically curable causes of hyperaldosteronism but remains markedly  underused. Key factors contributing to the poor use of adrenal  venous sampling include the prevailing  perceptions that it is a technically challenging procedure, difficult to  interpret, and can be complicated by adrenal vein  rupture. In addition, the lack of uniformly accepted standards for the  performance of adrenal venous sampling contributes to its limited use.  Hence, an international panel of experts working at major referral centers was  assembled to provide updated advice on how to perform and interpret adrenal venous sampling. To this end, they were asked to use the PICO  (Patient or Problem, Intervention, Control or comparison, Outcome) strategy to  gather relevant information from the literature and to rely on their own  experience. The level of evidence/recommendation was provided according to  American Heart Association gradings whenever possible. A consensus was reached  on several key issues, including the selection and preparation of the patients  for adrenal venous sampling,  the procedure for its optimal performance, and the interpretation of its results  for diagnostic purposes even in the most challenging cases.

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