Adrenal venous sampling is recommended prior to adrenalectomy for all patients with hyperaldosteronism; however, cross-sectional imaging resolution continues to improve, while the procedure remains invasive and technically difficult. Therefore, certain patients may benefit from advancing straight to surgery. The objective of the study was to determine whether clinical and biochemical resolution varied for patients with primary aldosteronism with unilateral adenomas who underwent adrenal venous sampling vs those who proceeded to surgery based on imaging alone. Given the improved sensitivity of cross-sectional imaging in detection of adrenal tumors, adrenal venous sampling may be selectively performed in appropriate patients with clearly visualized unilateral adenomas without affecting outcomes. This may facilitate increased access to surgical cure for aldosterone-producing adenomas and will decrease the incidence of morbidities associated with the procedure.
Authors: Jessica W. Thiesmeyer, Timothy M. Ullmann, Alexia T. Stamatiou, Jessica Limberg, Dessislava Stefanova, Toni Beninato, Brendan M. Finnerty, Timothée Vignaud, Julie Leclerc, Thomas J. Fahey III, Laurent Brunaud, Eric Mirallie, Rasa Zarnegar
Keywords: adrenal venous sampling (AVS), outcomes
DOI Number: 10.1001/jamasurg.2020.5011 Publication Year: 2020
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