Technical aspects of adrenal vein sampling.

The most common cause of secondary hypertension is primary aldosteronism, with a prevalence of approximately 30% when screened by specialized hypertension clinics. Adrenal venous sampling is considered the standard for reliably distinguishing between unilateral and bilateral hormone secretion, with unilateral secretion being surgically curable. Success of adrenal vein sampling relies on appropriate patient selection, patient preparation, and recognition and catheterization of both adrenal veins. However, this procedure may prove technically challenging, particularly for inexperienced operators. This video (see Fig; available online at www.jvir.org) is designed to provide the viewer with details on the technical aspects of adrenal vein sampling by using the sequential technique in an immersive format with real-time table-top teaching. Indications, patient preparation, equipment selection, technique, and quality assurance are reviewed in detail, with the goal of providing practitioners an opportunity to successfully incorporate this procedure into their practice.