Safety and efficacy of bilateral superselective adrenal arterial embolization for treatment of idiopathic hyperaldosteronism: a prospective single-center study

作者全名："Mao, Min; Feng, Rui; Khan, Nouman Ali; Tao, Li; Tang, Ping; Zhao, Yongpeng; Chen, Jie; Li, Xin; Zhao, Hong; Shi, Qiuyue; Wang, Ling; Lyu, Fengjie; Asghar, Muhammad Arif; He, Yutian; Chang, Jing; Xiang, Rui"

作者地址："[Mao, Min; Feng, Rui; Khan, Nouman Ali; Tang, Ping; Zhao, Yongpeng; Chen, Jie; Li, Xin; Zhao, Hong; Shi, Qiuyue; Wang, Ling; Lyu, Fengjie; He, Yutian; Chang, Jing; Xiang, Rui] Chongqing Med Univ, Dept Cardiol, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Tao, Li] Chongqing Med Univ, Dept Radiol, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Asghar, Muhammad Arif] Chongqing Med Univ, Chongqing 400016, Peoples R China"

通信作者："Chang, J; Xiang, R (通讯作者)，Chongqing Med Univ, Dept Cardiol, Affiliated Hosp 1, Chongqing 400016, Peoples R China."

来源：BMC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001297622700001

JCR分区：Q2

影响因子：1.9

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Primary aldosteronism; Adrenal arterial ablation; Hypertension; Idiopathic hyperaldosteronism; Superselective adrenal arterial embolization

摘要："Objective This study aimed to assess the efficacy and safety of bilateral superselective adrenal arterial embolization (SAAE) in patients with bilateral idiopathic hyperaldosteronism (IHA), a subtype of PA. Methods Ninety-eight patients with bilateral IHA underwent bilateral SAAE between August 2022 and August 2023. Sixty-eight patients were followed up for up to 12 months. The study outcomes were evaluated using the criteria provided by the Primary Aldosteronism Surgical Outcome (PASO) guidelines. Results The mean reductions in systolic and diastolic blood pressure were 27.4 +/- 21.3 mmHg and 23.1 +/- 17.4 mmHg, respectively (p < 0.001). The rates of clinical success and biochemical success after adrenal artery ablation were 63.2% (43/68) and 39.7% (27/68), respectively. Overall, there were significant reductions in daily defined doses (DDD), aldosterone/renin ratio (ARR), and plasma aldosterone levels (p < 0.001). Plasma renin levels increased by a mean value of 10.4 +/- 39.0 pg/mL (p = 0.049), and potassium levels increased by 0.40 +/- 0.63 mmol/L (p < 0.001). No significant adverse events were reported during SAAE or the follow-up period of up to one year. Additionally, no abnormalities were detected by adrenal 68Ga-Pentixafor PET/CT scans before or after SAAE. Conclusion Bilateral SAAE appears to lead to sustained improvements in blood pressure and biochemical parameters in patients with bilateral PA, with minimal adverse effects. This suggests that bilateral SAAE could serve as an effective alternative approach for treating bilateral IHA, potentially curing this condition."

基金机构：Chongqing Science Committee

基金资助正文："Thanks to the new director of cardiology department Russell and the director of cardiac catheterization laboratory Ma Kanghua for their strong support to the development and application of this technology; Thanks to Dr. Pang Hua of nuclear medicine, Dr. Kang Hua Ma, director of cardiac catheterization, and Dr. Lily Guan and Dr. Jing Chen for their support in the radionuclide adrenal gland examination; Thanks to Director Lufa Jin and Dr. Wang Guoshu of Radiology Department for their support and assistance in adrenal gland MRA and accurate positioning of adrenal arteries by intraoperative imaging."