Adrenal Vein Sampling for Primary Aldosteronism: Recommendations From the Australian and New Zealand Working Group

Jun Yang; Damon A Bell; Richard Carroll; Cherie Chiang; Diane Cowley; Emma Croker; James C G Doery; Marianne Elston; Paul Glendenning; Julie Hetherington; Andrea R Horvath; Shanshan Lu-Shirzad; Elisabeth Ng; Amanda Mather; Nimalie Perera; Muddassir Rashid; Nirupa Sachithanandan; Jimmy Shen; Michael Stowasser; Michael J Swarbrick; Hong Lin Evelyn Tan; Moe Thuzar; Simon Young; Winston Chong

doi:10.1111/cen.15139

Adrenal Vein Sampling for Primary Aldosteronism: Recommendations From the Australian and New Zealand Working Group

Clin Endocrinol (Oxf). 2024 Oct 3. doi: 10.1111/cen.15139. Online ahead of print.

Authors

Jun Yang^{1

2}, Damon A Bell^{3

4}, Richard Carroll⁵, Cherie Chiang⁶, Diane Cowley⁷, Emma Croker⁸, James C G Doery^{2

9}, Marianne Elston¹⁰, Paul Glendenning¹¹, Julie Hetherington¹², Andrea R Horvath¹³, Shanshan Lu-Shirzad¹, Elisabeth Ng¹, Amanda Mather¹⁴, Nimalie Perera¹⁵, Muddassir Rashid^{16

17}, Nirupa Sachithanandan^{18

19}, Jimmy Shen²⁰, Michael Stowasser²¹, Michael J Swarbrick²², Hong Lin Evelyn Tan⁸, Moe Thuzar^{21

23}, Simon Young²⁴, Winston Chong²⁵

Affiliations

¹ Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia.
² Department of Medicine, Monash University, Clayton, Victoria, Australia.
³ Department of Clinical Biochemistry, Royal Perth Hospital and Fiona Stanley Hospital Network, Pathwest Laboratory Medicine, Perth, Western Australia, Australia.
⁴ Medical School, University of Western Australia, Perth, Western Australia, Australia.
⁵ Endocrinology, Diabetes, and Research Centre, Wellington Regional Hospital, Wellington, New Zealand.
⁶ Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁷ Princess Alexandra Hospital, Brisbane, Queensland, Australia.
⁸ Department of Endocrinology, John Hunter Hospital, Lambton Heights, New South Wales, Australia.
⁹ Monash Pathology, Monash Medical Centre, Clayton, Victoria, Australia.
¹⁰ Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand.
¹¹ Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia.
¹² Endocrinology and Metabolism Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
¹³ Department of Chemical Pathology, New South Wales Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
¹⁴ Department of Renal Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
¹⁵ Department of Endocrinology and Chemical Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
¹⁶ Department of interventional radiology, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
¹⁷ Bond University Medical School, Gold Coast, Queensland, Australia.
¹⁸ Department of Endocrinology, St Vincent's Hospital, Fitzroy, Victoria, Australia.
¹⁹ Department of Medicine, The University of Melbourne, Parkville, Australia.
²⁰ Monash Medical Centre, Clayton, Victoria, Australia.
²¹ Endocrine Hypertension Research Centre, University of Queensland Frazer Institute, Brisbane, Australia.
²² Department of Radiology, Waikato Hospital, Hamilton, New Zealand.
²³ Department of Endocrinology, Princess Alexandra Hospital, Wooloongabba, Queensland, Australia.
²⁴ Department of Endocrinology, North Shore Hospital, North Auckland, New Zealand.
²⁵ Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.

PMID: 39360599
DOI: 10.1111/cen.15139

Abstract

Adrenal vein sampling (AVS) is the current recommended procedure for identifying unilateral subtypes of primary aldosteronism (PA), which are amenable to surgery with the potential for cure. AVS is a technically challenging procedure usually undertaken by interventional radiologists at tertiary centres. However, there are numerous variations in AVS protocols relating to patient preparation, sampling techniques and interpretation which may impact the success of AVS and patient care. To reduce practice variations, improve the success rates of AVS and optimise patient outcomes, we established an Australian and New Zealand AVS Working Group and developed evidence-based expert consensus recommendations for the preparation, performance and interpretation of AVS. These recommendations can be used by all healthcare professionals in a multidisciplinary team who look after the diagnosis and management of PA.

Keywords: adrenal vein sampling; conn syndrome; endocrine hypertension; hyperaldosteronism; hypertension; primary aldosteronism; subtyping.

Publication types

Review

Grants and funding

This study was supported by Medical Research Future Fund (MRFF, MRFAR000172).