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Table 5 Marked heterogeneity of basic procedural aspects of AVS

From: Adrenal vein sampling: technique and protocol, a systematic review

Study

Cosyntropin use

Sequential v simultaneous

Selectivity index

Lateralization index

SPARTICUS (Dekkers et al. 2016)

Cont. infusion

sequential

≥3

≥4.0 w/ CSI ≤1

Deipolyi (Deipolyi et al. 2015)

Cont. infusion

sequential

˃3

˃4

Kocjan (Kocjan et al. 2020)

Cont. infusion

sequential

˃5

˃4

Pasternak (Pasternak et al. 2016)

Cont. infusion

sequential

NR

≥4

Ota (Ota et al. 2016)

Bolus 250 μg, sample 15 min later

Simultaneous

≥5

NR

Miotti (Citton et al. 2015; Miotto et al. 2009)

No stim

Simultaneous

≥1.1

≥2.0

Conn (Vonend et al. 2011)

No stim

Sequential

≥2

≥3

Wolley (Wolley et al. 2015)

No stim

Sequential

≥3

≥2^ with CSI ≤1

Lee (Lee et al. 2020)

Bellavance (Bouchard-Bellavance et al. 2020)

Pre and post 250mcg bolus

Simultaneous

≥3 Pre

≥5 Post

> 2 pre cosyntropin

> 4 post cosyntropin

Teng (Teng et al. 2015)

Pre and post (bolus + infusion)

Sequential

> 2 Pre cosyntropin

> 3Post cosyntropin

> 3 Pre cosyntropin

> 4 Post cosyntropin

Webb (Webb et al. 2012)

Pre and post (bolus + infusion)

Simultaneous

> 5

> 4

Japanese Endocrine (Nishikawa et al. 2011)

250 μg cosyntropin bolus

Simultaneous

≥5 and ≥ 200 μg/dl cortisol

≥2.6 or unilateral aldosterone ≥14,000 pg/ml

Funder (Funder et al. 2016)

No conclusive rec

No conclusive rec

> 5 with cosyntropin

> 2 without cosyntropin

> 4 with cosyntropin

> 2 without cosyntropin

Expert Consensus (Rossi et al. 2014)

No conclusive rec

No conclusive rec

≥3 with cosyntropin

≥2 without cosyntropin

≥4 with cosyntropin

≥2 without cosyntropin

  1. NR = not reported. ^Wolley et al. used a modified lateralization index of (Dominant Adrenal Aldosterone/Cortisol)/(IVC Aldosterone/Cortisol) ≥2 and a CSI ≤1