Adrenal venous sampling (AVS), with or without adrenocorticotropic hormone (ACTH) stimulation, is the test of choice to identify patients with a surgically curable subtype of primary aldosteronism (PA). Whether AVS with ACTH stimulation is more effective than AVS without ACTH stimulation remains controversial. The objective of the study was to compare the effectiveness of AVS with ACTH stimulation and AVS without ACTH stimulation in patients with PA. The Cochrane Library, PubMed, Embase, and Web of Science databases were searched to identify relevant articles. All cohort studies comparing the two techniques (AVS with ACTH stimulation and AVS without ACTH stimulation in a patient with PA) were included in the analysis. AVS with ACTH stimulation can significantly reduce the number of unsuccessful cannulations, without significantly reducing the number of incorrect lateralization. Further studies are still needed to verify these findings.
