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Table 7 Results from AVS in a 31y/o female with a history of hypertension and hypokalemia who was found to have PA by ARR (237). CT (not shown) showed normal appearing bilateral adrenal glands. Samples were taken with continuous cosyntropin infusion at 50 μg/hr. Left sided sampling was done in the common phrenic adrenal trunk. Ratios between the adrenal vein cortisol and IVC cortisol, the SI, are used to determine sampling adequacy. In this case SI on the right is 38.1 (914/24) and 6.6 (159/24) on the left, the latter number lower because of dilution from the inferior phrenic vein. The lateralization index is 20 (7.2/.35) with a CSI of 0.16 (.35/2.2). The patient underwent left adrenalectomy with hypertension and biochemical cure

From: Adrenal vein sampling: technique and protocol, a systematic review

 

Aldosterone (ng/dl)

Cortisol (μg/dl)

A/C ratio

Right Adrenal Vein

319

914

0.35

Left Adrenal Vein

1144

159

7.2

Inferior Vena Cava

52

24

2.2