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Adrenal Vein Sampling
An adrenal vein sampling procedure helps differentiate bilateral adrenal hyperplasia from an aldosterone-secreting adenoma. These two processes have different treatments, typically surgical for adenoma and medical management for hyperplasia. It can be tedious work, but with the appropriate preparation and understanding of the anatomy, an adrenal vein sampling (AVS) procedure can be accomplished safely and efficiently.

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Pre-Procedure Prep
Adrenal Vein Sampling Indications
• Identification of primary aldosteronism and localization of aldosterone-producing adenoma.
• Confirm adrenal gland as excess cortisol source in Cushing syndrome.
• Elevated cortisol lateralizing to adrenal vein in presence of adrenal mass is confirmatory of endogenous Cushing syndrome
Contraindications
• Adrenalectomy/ablation not possible due to multiple comorbidities