Abstract-In patients with primary aldosteronism, adrenal venous sampling is helpful to distinguish between unilateral and bilateral adrenal diseases. However, the procedure is technically challenging, and selective bilateral catheterization often fails. The aim of this analysis was to evaluate success rate in a retrospective analysis and compare data with procedures done prospectively after introduction of measures designed to improve rates of successful cannulation. Patients were derived from a cross-sectional study involving 5 German centers (German Conn's registry Key Words: primary aldosteronism Ⅲ adrenal vein sampling Ⅲ aldosterone-producing adenoma Ⅲ bilateral idiopathic hyperaldosteronism Ⅲ rapid cortisol assay P rimary hyperaldosteronism (PA) is one of the common causes of secondary hypertension. 1,2 However, guidelines for screening, confirmatory testing, and procedures to differentiate between unilateral and bilateral disease are rare, 3 and cutoff parameters are not prospectively evaluated. More than 98% of patients with PA present with unilateral aldosteroneproducing adenoma (APA) or bilateral idiopathic hyperaldosteronism (IHA). In addition, there are monogenetic forms of PA. 4,5 However, therapy of the 2 subtypes APA and IHA differs substantially. Although hypertension attributed to unilateral APA can be cured surgically by adrenalectomy, IHA is treated by mineralocorticoid receptor antagonists.

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