{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:30:55Z","timestamp":1760189455071},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,1,21]],"date-time":"2016-01-21T00:00:00Z","timestamp":1453334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The role of adrenal vein sampling (AVS) has been debated, with some authorities advocating selective use in younger patients (\u226440 years), and those localized by preoperative imaging. We examined our experience to determine the impact of AVS in patients who routinely underwent AVS with a high success rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was performed using a prospectively maintained database of patients referred for evaluation of PA (1997\u20132013). Patients were classified as localized (L) if a unilateral mass was identified on imaging, and non\u2010localized (NL) otherwise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 367 patients, 94% (n\u2009=\u2009345) underwent successful AVS. Seventy\u2010two percent (n\u2009=\u2009265) were L; AVS was lateralizing 58% (n\u2009=\u2009214). AVS changed management in 43% of patients (n\u2009=\u2009158). In patients \u226440 years, AVS changed management in 30% (n\u2009=\u200915). In patients \u226440 years with a \u22651\u2009cm adrenal mass, 12% (n\u2009=\u20093) would have undergone unnecessary surgery based on imaging results alone; in patients &gt;40 years with a \u22651\u2009cm adrenal mass, 3% (n\u2009=\u20095) would have undergone wrong\u2010side surgery, and 30% (n\u2009=\u200950) would have undergone unnecessary surgery based on imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>AVS changed management in a significant minority of patients regardless of age and imaging findings. AVS should be routinely recommended in all patients with PA, to direct operative therapy. <jats:italic>J. Surg. Oncol. 2016;113:532\u2013537<\/jats:italic>. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.24182","type":"journal-article","created":{"date-parts":[[2016,1,21]],"date-time":"2016-01-21T05:56:45Z","timestamp":1453355805000},"page":"532-537","source":"Crossref","is-referenced-by-count":19,"title":["Role of adrenal vein sampling in primary aldosteronism: Impact of imaging, localization, and age"],"prefix":"10.1002","volume":"113","author":[{"given":"Heather","family":"Wachtel","sequence":"first","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salman","family":"Zaheer","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parth K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Surgery Creighton University Medical Center Omeha Nebraska"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott O.","family":"Trerotola","sequence":"additional","affiliation":[{"name":"Department of Radiology Division of Vascular and Interventional Radiology Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgos C.","family":"Karakousis","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Roses","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie L.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Renal, Electrolyte, and Hypertension Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas L.","family":"Fraker","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60834-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200411000-00026"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02775.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0104"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.20.85"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2006.02.002"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000230444.01215.6a"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.01.015"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.01060"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0681"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.27.5.1039"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.110.168484"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.3.1066"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.06.051"},{"key":"e_1_2_6_16_1","first-page":"707","article-title":"Diagnostic evaluation of the adrenal incidentaloma: Decision and cost\u2010effectiveness analyses","volume":"39","author":"Dwamena BA","year":"1998","journal-title":"J Nucl Med"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3282f9e66a"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2014.06.029"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000134495.26900.6A"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(96)80033-X"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-3789"},{"key":"e_1_2_6_22_1","first-page":"299","article-title":"Primary hyperaldosteronism and adrenal incidentaloma: An argument for physiologic testing before adrenalectomy","volume":"41","author":"McAlister FA","year":"1998","journal-title":"Can J Sur"},{"key":"e_1_2_6_23_1","first-page":"637","article-title":"A survey on adrenal incidentaloma in Italy. 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