Conclusions
In this RCT, treatment of PA on the basis of non–ACTH-stimulated or ACTH-stimulated AVS did not lead to significant differences in biochemical and clinical outcomes for the patients. In the diagnostic workup of patients with PA, ACTH infusion during AVS adds another layer of complexity to an already challenging procedure. Our results suggest that ACTH-stimulated AVS does not offer additional benefit compared with nonstimulated AVS, at least in the Chinese population.