{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T20:18:26Z","timestamp":1778098706262,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Current guidelines recommend adrenal venous sampling (AVS) for subtyping primary aldosteronism (PA). However, bilateral adrenal cannulation failure is common especially at low\u2010volume centers. The role of unilateral\u2010cannulating AVS in selecting patients for unilateral adrenalectomy is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty consecutive patients underwent AVS between 2009 and 2023 and thirty\u2010three (66%) underwent unilateral adrenalectomy. We defined unilateral PA (uPA) by the normalized plasma aldosterone and the aldosterone\u2013renin ratio following unilateral adrenalectomy. We examined the effectiveness of unilateral\u2010cannulating AVS in identifying uPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>88%, 50%, and 48% of patients had the left, right, and bilateral adrenal veins successfully cannulated, respectively. Among patients with bilateral successful cannulation, a lateralization index (LI)\u00a0&gt;\u00a04 provided a sensitivity of 100% and a positive predictive value (PPV) of 86.7% for uPA. Thresholds for the contralateral suppression index (CSI) and relative aldosterone secretion index (RASI) were derived from this subgroup and applied to the entire cohort. CSI &lt;0.5 demonstrated a sensitivity of 76.5% and PPV of 92.9% for uPA, whereas RASI &gt;2.4 showed a sensitivity of 85.0% and PPV of 94.4% for uPA. With CSI &lt;0.5 or RASI &gt;2.4 combined, a higher PPV (95.5%) was achieved when compared to computed tomography and iodocholesterol scintigraphy (86.2% and 62.5%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite unsuccessful bilateral cannulation, our study confirms that unilateral\u2010cannulating AVS can effectively select patients for unilateral adrenalectomy based on a combination of CSI or RASI criteria.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12402","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T03:23:39Z","timestamp":1731900219000},"page":"2941-2949","source":"Crossref","is-referenced-by-count":3,"title":["Role of unilateral\u2010cannulating adrenal venous sampling for the subtyping of primary aldosteronism for adrenalectomy: Experience from a low\u2010volume center"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9460-0178","authenticated-orcid":false,"given":"Chi\u2010Man Tom","family":"Chow","sequence":"first","affiliation":[{"name":"Department of Surgery Alice Ho Miu Ling Nethersole Hospital Hospital Authority  Hong Kong China"},{"name":"Division of Endocrine Surgery Department of Surgery the Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1359-3290","authenticated-orcid":false,"given":"Man Sze Carol","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Surgery Alice Ho Miu Ling Nethersole Hospital Hospital Authority  Hong Kong China"},{"name":"Division of Endocrine Surgery Department of Surgery the Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3107-4155","authenticated-orcid":false,"given":"Xina","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Surgery Alice Ho Miu Ling Nethersole Hospital Hospital Authority  Hong Kong China"},{"name":"Division of Endocrine Surgery Department of Surgery the Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3882-8885","authenticated-orcid":false,"given":"Yuk Wah Shirley","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery Alice Ho Miu Ling Nethersole Hospital Hospital Authority  Hong Kong China"},{"name":"Division of Endocrine Surgery Department of Surgery the Chinese University of Hong Kong  Hong Kong 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