Adrenal Venous Sampling (AVS)

Adrenal venous sampling is an outpatient procedure that takes place in a hospital or surgical center. You’ll be awake for the procedure, but not feel any pain. This is performed with local anesthetic or conscious/light sedation. If you receive sedation, someone will need to drive you home after AVS.

Your healthcare provider may ask you to stop taking certain medications in the days leading up to AVS. Be sure to let your provider know which medications you take. You’ll also have to avoid eating or drinking the morning of the procedure.

You can expect the following to occur during AVS:

1. Your healthcare provider will give you medication through an IV to stimulate your adrenal glands. An IV is a thin tube with a needle on the end. It can deliver medication directly into your bloodstream (through a vein).
2. You may also receive medication through the IV to relax you (sedation).
3. Your provider will apply an anesthetic to your groin to numb the area. This is where they’ll place the catheter. You won’t feel pain when they insert the catheter since your groin will be numb.
4. The interventional radiologist will make a cut in your groin. Then, they’ll pass a catheter into one of the veins in your groin. They’ll use an ultrasound to make sure they’re finding the right vein.
5. Next, they’ll insert a contrast material through the catheter. They’ll use an X-ray to guide the catheter up to your adrenal gland veins. (The X-ray will show them where the veins are.)
6. Once they find the veins, they’ll take a blood sample from both the right and left adrenal veins.
7. Then, they’ll remove the catheter from your groin and cover the incision with a bandage.

No, it shouldn’t hurt. You’ll receive medication so you don’t feel pain during the procedure. Some people say they feel warmth when the contrast material spreads through their veins. This is brief and shouldn’t be painful.

The procedure can take up to two hours. Afterward, you’ll rest in a recovery room, which could take another two to four hours. Since everyone is different, you should always ask your healthcare provider how long you can expect AVS to last.

After your healthcare provider gets the blood samples from your adrenal veins and removes the catheter, you’ll go to a recovery room. The blood samples are sent to a lab. A lab technician studies both samples to determine which gland is producing excess aldosterone.

Your healthcare team will monitor your vital signs while in the recovery room. Once this happens, and if your vitals remain stable, you’ll be discharged and sent home.

You should plan on resting for at least the next 24 to 72 hours. Your provider may give you rules to follow so your recovery goes smoothly. Ask your healthcare provider if you need to modify your daily routine while you recover.

The results tell your provider if primary aldosteronism comes from one adrenal gland or both adrenal glands.

• If just one adrenal gland is producing too much aldosterone, your provider may recommend removing the gland (adrenalectomy) as treatment for primary aldosteronism.
• If both glands are overproducing aldosterone, medication is usually the best treatment.