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Rofo 2021; 193(06): 658-666
DOI: 10.1055/a-1299-1878
Review

Update: Selective adrenal venous sampling (AVS) – Indication, technique, and significance

Article in several languages: English | deutsch
Christina Loberg
1   University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
,
Gerald Antoch
1   University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
,
Johannes Stegbauer
2   Department of Nephrology, Medical Faculty, Heinrich‐Heine‐University Düsseldorf, Düsseldorf, Germany
,
Till Dringenberg
3   Division for Specific Endocrinology, University Hospital Düsseldorf, Düsseldorf, Germany
,
Andrea Steuwe
1   University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
,
Günter Fürst
1   University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
,
Matthias Haase
3   Division for Specific Endocrinology, University Hospital Düsseldorf, Düsseldorf, Germany
,
Lars Christian Rump
2   Department of Nephrology, Medical Faculty, Heinrich‐Heine‐University Düsseldorf, Düsseldorf, Germany
,
Lars Schimmöller 
1   University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
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Abstract

Background Primary aldosteronism (PA) is the most common detectable cause of secondary hypertension. The majority of patients have either an adrenal aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia (BAH) demanding different therapeutic approaches. Screening tests and imaging cannot reliably distinguish between a unilateral or bilateral PA.

Methods This review article gives an overview concerning etiology, diagnostics, and therapeutic options of PA, and reviews the indication, the technique, and relevance of selective adrenal venous sampling (AVS) in the context of the current literature and the authors’ experience.

Results AVS can verify or exclude a unilaterally dominated secretion with a high success rate. Patients with PA and a unilateral APA can be treated curatively by adrenalectomy.

Conclusions AVS is an established diagnostic examination for differentiation of unilateral from bilateral adrenal disease in patients with PA.

Key Points:

  • Selective adrenal venous sampling (AVS) is a safe, reliable, and minimally invasive method to detect a unilateral or bilateral adrenal adrenal gland disease.

  • Verification of lateralization by AVS has direct therapeutic relevance for patients with primary aldosteronism (PA).

  • AVS can be performed with low radiation exposure, without contrast medium, and with a high success rate when performed by an experienced interventional radiologist.

Citation Format

  • Loberg C, Antoch G, Stegbauer J et al. Update: Selective adrenal venous sampling (AVS) – Indication, technique, and significance. Fortschr Röntgenstr 2021; 193: 658 – 666

Key words

adrenal gland - interventional procedures - angiography - blood - hypertension


Publication History

Received: 03 July 2020

Accepted: 19 October 2020

Article published online:
16 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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