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Adrenal venous sampling not always required before unilateral adenoma treatment


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Journal
JAMA Surgery
Reuters Health - 12/11/2020 - In patients with primary aldosteronism and clearly visualized unilateral adenomas, confirmatory adrenal venous sampling (AVS) may not be required prior to surgery, researchers say. "It's important to realize that AVS is not a benign procedure," Dr. Rasa Zarnegar of Weill Cornell Medicine in New York City told Reuters Health by email. "Given the high sensitivity of current cross-sectional imaging, with careful identification and the right clinical setting, AVS can be avoided in the treatment algorithm of primary aldosteronomas - irrespective of age - with solitary adrenal nodules greater than 1 cm." "There are complications with AVS and additional cost," he noted. "Procedures that rarely improve outcomes in the correct clinical setting should be evaluated for risk and benefits prior to implementing." "Bypassing AVS is based on surgeon and endocrinology experience as well as the expertise of AVS in different locations," he added. "...


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