Improving the success and reliability of adrenal venous sampling: focus on intraprocedural cortisol measurement

[...]recently published guidelines have recommended wider screening for PA via testing for the plasma aldosterone/renin ratio, in an effort to maximize the detection of patients who may then benefit from optimal, specific management (4 ). According to the criteria used in our center, if the aldosterone/ cortisol ratio on one side is at least 2 times greater than the simultaneous peripheral venous ratio, and the aldosterone/cortisol ratio on the other side is no higher than peripheral venous ratio, the study is considered to show lateralization, indicating that unilateral adrenalectomy should cure or improve the hypertension (2 ).