Hypothesis: Adrenal vein sampling is superior to computed tomography for subtype differentiation of primary hyperaldosteronism. Design: Retrospective review. Setting: University medical center. Patients: Forty-eight patients (32 men and 16 women) with biochemically confirmed primary hyperaldosteronism. Main Outcome Measures: We compared demographic factors, results of biochemical and imaging studies (computed tomography and adrenal vein sampling), therapy, and patient outcomes. Results: Mean±SEM adrenal nodule size was 1.54±0.2 cm. Adrenal vein sampling was performed in 41 (85%) of 48 patients, and it was successful in 39 (95%) of those 41 patients. Concordance between computed tomography and adrenal vein sampling was observed in 22 (54%) of the 41 patients. Thirty-two patients underwent successful laparoscopic adrenalectomy. There was 1 complication and no deaths. All 32 patients were cured of hypokalemia. Conclusion: Adrenal vein sampling is superior to image-based techniques for subtype differentiation of primary hyperaldosteronism.
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