{
  "abstract": "Primary aldosteronism is the cause of secondary arterial hypertension in up to 10–12% of patients with elevated blood pressure. In approximately one-third of these cases, the excess aldosterone production is lateralised to either the right or left adrenal gland, often due to an aldosterone-secreting adenoma. However, identifying the precise source of aldosterone hyperproduction via cross-sectional imaging is challenging, as imaging cannot reliably distinguish between hormone-active and inactive adenomas. This is further complicated by the higher prevalence of inactive adenomas. To address this limitation, adrenal vein sampling is a reliable method for determining the lateralisation of pathological aldosterone production.In this report, we present the case of a male patient in his early 50s who was diagnosed with primary aldosteronism and underwent adrenal vein sampling under difficult circumstances due to a rare anatomical variant in the adrenal venous system. Specifically, we describe our approach to successful catheterisation of the central adrenal vein in the setting of an accessory hepatic vein drainage, a condition present in about 10% of patients.This case underscores the need for accurate pre-interventional imaging and the use of appropriate interventional techniques during adrenal vein sampling to reliably localise the source of aldosterone hyperproduction.",
  "authors": [
    {
      "affiliations": [
        "Internal Medicine I, Ulm University Hospital, Ulm, Baden-Wuerttemberg, Germany"
      ],
      "name": "Alexander Becher"
    },
    {
      "affiliations": [
        "Radiology, Ulm University Hospital, Ulm, Baden-Wuerttemberg, Germany"
      ],
      "name": "Christoph Gerhard Lisson"
    },
    {
      "affiliations": [
        "Internal Medicine I, Ulm University Hospital, Ulm, Baden-Wuerttemberg, Germany"
      ],
      "name": "Roza Sabia"
    },
    {
      "affiliations": [
        "Internal Medicine I, Ulm University Hospital, Ulm, Baden-Wuerttemberg, Germany"
      ],
      "name": "Gisa Ufer"
    },
    {
      "affiliations": [
        "Internal Medicine I, Ulm University Hospital, Ulm, Baden-Wuerttemberg, Germany"
      ],
      "name": "Martin Heni"
    }
  ],
  "title": "Successful adrenal vein sampling in primary aldosteronism in an anatomical variant with accessory hepatic vein drainage",
  "uid": "20a7f7a1-d61e-51e3-ba35-3f42922d628a"
}