Revisiting Adrenal Vein Sampling Interpretation in Primary Aldosteronism

Adrenal vein sampling (AVS) is widely used for subtyping primary aldosteronism and guiding surgical decision-making. However, its interpretation is challenging, as protocols and interpretive indices vary widely across centers. In addition, several clinical and analytical conditions that can interfere with AVS interpretation may be underrecognized in clinical practice. This review summarizes the fundamental principles of AVS interpretation and discusses conditions that may confound diagnostic accuracy, as well as areas of ongoing controversy in contemporary practice.