ltl

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if the AVS is not done with 2 caths so simultaneous sampling is done, ACTH may kick off in going from right to left and give a false + test. Guess your radiologist uses 2 caths and is very quick in getting both sides at the same time. And it is more difficult to tell if you are in a hepatic vein or a R adrenal. Most who have done a lot prefer ACTH. As does the Endocrin. Soc Guidelines mostly.Guess he missed them. Let us see your results when you get them. Good luck. On Jun 13, 2012, at 12:09 AM, Virginia Wall wrote: Thanks . , If I understood this article correctly, it seems as though the radiologist was able to get conclusive results in 's case even without ACTH? Since it appears she successfully "lateralized"? How do we know if the results were innaccurate? Sorry, I am trying to learn but a lot of this is still too technical for me. I appreciate the question because I've been wondering myself. , were you DASHing before your AVS?Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5 month old with G6PDDOn Jun 12, 2012, at 8:57 PM, " " <jclark24p@...> wrote: , please review this article, it's probably better than a "chill pill"! : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2930893/?tool=pubmedConsequences of Adrenal Venous Sampling in Primary Hyperaldosteronism and Predictors of Unilateral Adrenal DiseaseNote: One of the authors, Dr. E. Chang, is the IR at NIH and does most if not all AVSs done there. The day he did mine I was the third case that day - he knows what he is talking about! (I personally think if you have an experienced IR you are better off letting him do what he is comfortable with. He knows how to do and interpret his procedure.)You will be well served if you skip directly to the discussion and note "Moreover, the most accurate measurement for AVS lateralization was the post-ACTH stimulation AC ratio, although a majority of patients can be localized without ACTH stimulation" and "pre-ACTH stimulation values successfully lateralized in 95% of patients, and the addition of ACTH allowed 98% of patients to lateralize">> Hi everyone, I hope you are all enjoying your summer. I had my AVS last week Wed. I am still awaiting results. However, I just read in a response to Virginia Wall to make sure they use ACTH. (By the way, good luck Virginia...it was a piece of cake!) Anyway, I am about to cry. The interventional radiologist that did my AVS, specifically said he does NOT use ACTH. He said something to the affect that if they use ACTH they get more inconclusive results than with ACTH. The percentage of difference needs to be MUCH higher with ACTH than without. I can't remember the percentages off hand, but it was a major difference. He also said there could be problems if too much ACTH was used, etc. In his opinion the risk outweighed the benefit (which he never actually told me what the "benefit" would be). I finally felt like I found a good doctor because he was so careful to explain this to me and it seemed perfectly logical. Aaagghhh!! Can someone explain to me why ACTH SHOULD be used? Any idea what the chances are of my AVS results being accurate considering it was not used?> > > 39 y/o female (almost 40)> 2cm adenoma on left adrenal> Currently on SEVEN 20meg K supplements per day> Verapamil SR 180 mg> BP creeping back up into high 140's/80s or 90s>