{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T03:33:19Z","timestamp":1764905599755},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,11,13]],"date-time":"2015-11-13T00:00:00Z","timestamp":1447372800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Royal Australasian College of Physicians Foundation for High Blood Pressure Research Establishment Fellowship"},{"name":"NHMRC Principle Senior Research Fellowship","award":["1002559"],"award-info":[{"award-number":["1002559"]}]},{"name":"Victorian Government's Operational Infrastructure Program"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2015,11]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Adrenal vein sampling (AVS<\/jats:styled-content>) is useful for distinguishing unilateral versus bilateral hypersecretion in primary aldosteronism (PA<\/jats:styled-content>), but is technically challenging. Furthermore, the use of adrenocorticotropic hormone (ACTH<\/jats:styled-content>)\u2010stimulation in AVS<\/jats:styled-content> is controversial. We implemented a M<\/jats:styled-content>onash H<\/jats:styled-content>ealth\u2010specific AVS<\/jats:styled-content> protocol in 2010.<\/jats:p><\/jats:sec>Aim<\/jats:title>The audit aimed to: (i) examine the impact of a dedicated protocol on success rates of AVS<\/jats:styled-content> at a tertiary referral centre; (ii) evaluate the impact of AVS<\/jats:styled-content> on sub\u2010typing of PA<\/jats:styled-content>; and (iii) assess the utility of ACTH<\/jats:styled-content> stimulation in AVS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>AVS<\/jats:styled-content> was performed on patients with PA<\/jats:styled-content> confirmed by positive saline suppression testing (aldosterone level >140\u2009pmol\/L post\u2010saline infusion), with sequential sampling of adrenal and peripheral veins, pre\u2010 and post\u2010ACTH<\/jats:styled-content> infusion. Patients with unilateral aldosterone\u2010producing adenoma diagnosed on successful AVS<\/jats:styled-content> were referred for adrenalectomy.<\/jats:p><\/jats:sec>Results<\/jats:title>Between 2010 and 2014 inclusive, a total of 28 AVS<\/jats:styled-content> procedures was performed, with complete pre\u2010 and post\u2010ACTH<\/jats:styled-content> data for 19 procedures. Bilateral successful cannulation rates improved post\u2010implementation of our protocol (61% vs 41%). Of the patients, 32% had discordant imaging and AVS<\/jats:styled-content> results: four patients with unilateral adenomas did not lateralise on AVS<\/jats:styled-content> and were managed medically; four patients with bilateral or no adenomas on imaging, lateralised on AVS<\/jats:styled-content> and had surgery. Overall, use of ACTH<\/jats:styled-content> did not increase successful cannulation and tended to mask lateralisation.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>AVS<\/jats:styled-content> is crucial in subtype classification of PA<\/jats:styled-content> and should be performed by a dedicated radiologist with a standardised protocol. AVS<\/jats:styled-content> outcomes were not improved with the use of ACTH<\/jats:styled-content> stimulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12873","type":"journal-article","created":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T06:25:16Z","timestamp":1439187916000},"page":"1141-1146","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Role of adrenal vein sampling in primary aldosteronism: the M<\/scp>onash H<\/scp>ealth experience"],"prefix":"10.1111","volume":"45","author":[{"given":"J.","family":"Teng","sequence":"first","affiliation":[{"name":"Department of Endocrinology Monash Medical Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. E.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Medical Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. C. G.","family":"Doery","sequence":"additional","affiliation":[{"name":"Monash Pathology Monash Medical Centre Melbourne Victoria Australia"},{"name":"Department of Medicine Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. W.","family":"Choy","sequence":"additional","affiliation":[{"name":"Monash Pathology Monash Medical Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Chong","sequence":"additional","affiliation":[{"name":"Monash Imaging Monash Medical Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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