ArticleJournal of vascular and interventional radiology : JVIR2021
"Double-Down" Adrenal Vein Sampling Results in Patients with Apparent Bilateral Aldosterone Suppression: Utility of Repeat Sampling including Super-Selective Sampling.
Article in Journal of vascular and interventional radiology : JVIR, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Adrenal Vein Sampling for Primary Aldosteronism: Recommendations From the Australian and New Zealand Working Group.Clinical endocrinology · 2025Guideline
- Partially Successful Adrenal Vein Sampling With and Without Cross-Sectional Imaging in Primary Aldosteronism Subtyping.Hypertension (Dallas, Tex. : 1979) · 2026Article
- The Gravity of Technique: Considerations Regarding Adrenal Vein Sample Collection.Cardiovascular and interventional radiology · 2025Article
- Resolution of paradoxical bilateral aldosterone suppression with mass spectrometry.European journal of endocrinology · 2025Article
- Role of radiologists in the diagnosis and management of adrenal disorders.Endocrine journal · 2025Review
- Predicting Unilateral Aldosterone Secretion in Primary Aldosteronism.The Journal of surgical research · 2025Article
- Case Report: Anomalous drainage vein sampling for diagnosing aldosterone-producing lesions undetectable by segmental adrenal venous sampling in a two-case series.Frontiers in radiology · 2025Article
- Segmental Adrenal Venous Sampling in Unilateral Primary Aldosteronism With Apparent Bilateral Aldosterone Suppression.JCEM case reports · 2024Article
- Utility of Repeat Sampling in Bilateral Aldosterone Suppression During Adrenal Vein Sampling for Primary Aldosteronism.JCEM case reports · 2024Article
- Adrenalectomy for primary aldosteronism and its related surgical characteristics.Frontiers in endocrinology · 2024Review
- High aldosterone levels in the renal capsular vein from the left aldosterone-producing adenoma on adrenal venous sampling.Endocrinology, diabetes & metabolism case reports · 2023Article
- Techniques in adrenal vein sampling: Multipurpose catheter shape facilitates sampling of cranially oriented right adrenal veins.Diagnostic and interventional radiology (Ankara, Turkey) · 2022Article
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5 authors at 1 institution in 1 country.
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Abstract
purposeTo report outcomes of patients undergoing adrenal vein sampling (AVS) for primary aldosteronism with results indicating apparent bilateral adrenal suppression (ABAS), in which the adrenal aldosterone-to-cortisol ratios are decreased bilaterally ("double-down") compared to the non-adrenal sample, and evaluate repeat AVS results. MATERIALS AND
methodsBetween 2003 and 2020, 762 patients underwent AVS. Twenty patients (2.6%; male, 12; female, 8; age 50.3 ± 9.7 years) with ABAS on initial AVS were identified. Ten underwent repeat AVS. Super-selective AVS (SS-AVS) was employed in 6 of 10 repeat AVS (60%). Outcomes after AVS were analyzed. A lateralization index (LI) >4 was considered an indication for adrenalectomy.
resultsRepeat AVS was diagnostic in 70% of patients (n = 7), with 6 of 7 lateralizing with LI >4 (median LI = 32.3; range 4.6-54.8) and 1 of 7 nearly lateralizing (LI = 3.5). All 7 patients underwent adrenalectomy. ABAS was redemonstrated in 3 patients (30%): 2 with unilateral adenomas on cross-sectional imaging underwent adrenalectomy despite ABAS results and 1 was lost to follow-up. Four of 6 patients (66%) who underwent SS-AVS were diagnosed with unilateral disease (median LI = 43.3; range 23.9-54.8), with one patient's diagnosis reliant upon a single super-selective sample. In total, 9 patients underwent adrenalectomy after repeat AVS, all of whom had improved blood pressure control postoperatively. Ten patients did not undergo repeat AVS: 6 were lost to follow-up, 3 underwent medical management, and 1 underwent adrenalectomy.
conclusionsAVS should be repeated when "double-down" ABAS results are encountered. Super-selective sampling may provide worthwhile diagnostic data when employed during repeat AVS.
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