Question 1

What is the Meaning of Adrenal Vein Sampling?

Accepted Answer

Adrenal Vein Sampling (AVS) is a specialized, minimally invasive diagnostic procedure. It involves selective catheterization of adrenal veins to collect blood samples directly from each adrenal gland. This technique allows precise measurement of hormone concentrations, primarily aldosterone and cortisol, at their production site.

Question 2

What is the Context of Adrenal Vein Sampling?

Accepted Answer

This procedure functions within the endocrine system, specifically targeting the adrenal glands situated superior to the kidneys. These glands produce essential hormones like aldosterone, which regulates blood pressure and electrolyte balance. AVS is performed when autonomous hormone overproduction from one or both adrenal glands is clinically suspected.

Question 3

What is the Significance of Adrenal Vein Sampling?

Accepted Answer

AVS is crucial for accurate diagnosis and management of primary aldosteronism, a common cause of secondary hypertension. It precisely locates the source of excessive aldosterone secretion, differentiating unilateral adenoma from bilateral adrenal hyperplasia. This distinction guides appropriate treatment, like unilateral adrenalectomy or medical management, improving patient outcomes.

Question 4

What is the Mechanism of Adrenal Vein Sampling?

Accepted Answer

The procedure involves advancing a catheter from a femoral vein into the inferior vena cava, then selectively into the right and left adrenal veins. Blood samples are collected from each adrenal vein and a peripheral vein concurrently. These samples are analyzed for aldosterone and cortisol levels; cortisol confirms catheter placement.

Question 5

What is the Application of Adrenal Vein Sampling?

Accepted Answer

Clinically, AVS is applied in patients with confirmed primary aldosteronism who are surgical candidates. It is often a prerequisite for unilateral adrenalectomy, ensuring removal of the correct adrenal gland resolves hypertension. The procedure helps determine if one adrenal gland is predominantly responsible for excess aldosterone, guiding surgical versus medical therapy.

Question 6

What is the Metric of Adrenal Vein Sampling?

Accepted Answer

Adrenal Vein Sampling interpretation relies on specific biochemical metrics. Aldosterone and cortisol concentrations are measured in samples from each adrenal vein and a peripheral vein. A lateralization index, comparing the aldosterone-to-cortisol ratio from the dominant adrenal gland to the contralateral gland, determines unilateral excess. A selectivity index confirms catheterization.

Question 7

What is the Risk of Adrenal Vein Sampling?

Accepted Answer

While generally safe, Adrenal Vein Sampling carries potential risks. These include venous perforation or dissection, adrenal hemorrhage, and hematoma at the puncture site. Patients also experience ionizing radiation exposure during fluoroscopy. Complications, though uncommon, necessitate the procedure be performed by experienced interventional radiologists in specialized centers. Assessment mitigates adverse events.

Adrenal Vein Sampling

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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