The Long-term Effect of Adrenal Arterial Embolization for Unilateral Primary Aldosteronism on Cardiorenovascular Protection, Blood Pressure, and the Endocrinological Profile

Kometani, Mitsuhiro; Yoneda, Takashi; Demura, Masashi; Mori, Shunsuke; Oe, Masashi; Sawamura, Toshitaka; Okuda, Rika; Yamagishi, Masakazu; Takeda, Yoshiyu

doi:10.2169/internalmedicine.55.5196

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…If AH leads to hemodynamic instability, emergency resection of the affected adrenal gland will be required. If surgery cannot be conducted promptly, trans-catheter adrenal arterial embolization [ 22 ], which is a treatment option for unilateral PA, may be effective for AH.…”

Section: Discussionmentioning

confidence: 99%

Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling

et al. 2018

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Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage. Previous reports have also indicated that AH may not ameliorate PA. We discussed the clinical progress of AH and the measures to prevent causing AH.

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Section: Discussionmentioning

confidence: 99%

Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling

et al. 2018

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“…Inoue et al in 1993, who, with other research centers, reported encouraging long-term results [8][9][10]16. Hokotate et al reported 33 cases of APA treated by SAAE, with a mean follow-up duration of 45 months 10.…”

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confidence: 99%

Superselective adrenal arterial embolization for idiopathic hyperaldosteronism: 12‐month results from a proof‐of‐principle trial

Dong

Zou

et al. 2021

Cathet Cardio Intervent

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Objectives: This study aimed to assess the safety, blood pressure changes, and biochemical responses of superselective adrenal artery embolization (SAAE) in hypertensive patients with idiopathic hyperaldosteronism (IHA).Background: SAAE is a minimally invasive procedure that has been used to successfully treat aldosterone-producing adenoma. However, its effect for patients with IHA is unevaluated.Methods: A total of 41 hypertensive patients who were diagnosed with IHA and underwent SAAE at the Fuwai Hospital between December 2010 and June 2016 were prospectively enrolled. The blood pressure, antihypertensive medications, plasma aldosterone and potassium levels, and adverse events were assessed. The primary endpoint was the change in home blood pressure at 12 months, compared with baseline.Results: SAAE was technically successful in 39 patients. Postoperatively, home and 24-hr mean blood pressures were reduced by 14/9 and 10/7 mmHg at 1 month, respectively, and by 13/7 and 11/7 mmHg at 12 months, respectively. The number of antihypertensive agents used reduced by 1.0 and 1.1 at 1 month and 12 months, respectively (all p < .001). Compared with baseline (524.0 pmol/L), the standing plasma aldosterone reduced to 293.4 pmol/L at 12 months (p < .001). Serum potassium increased from 3.0 to 4.1 mmol/L while the rate of potassium supplement and mineralocorticoid receptor antagonist use reduced from 87.1 and 89.7%, respectively, to 28.2 and 17.9%, respectively, at 12 months (all p < .001). There were no serious complications in the perioperative and 12-month follow-up periods.Conclusions: SAAE was effective and feasible for IHA treatment, without serious complications, therefore, maybe a potential treatment.

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The impact of superselective adrenal artery embolization on renal function in patients with primary aldosteronism: a prospective cohort study

Lai,

Fu,

Liu

et al. 2023

Hypertens Res

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The Long-term Effect of Adrenal Arterial Embolization for Unilateral Primary Aldosteronism on Cardiorenovascular Protection, Blood Pressure, and the Endocrinological Profile

Cited by 3 publications

References 24 publications

Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling

Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling

Superselective adrenal arterial embolization for idiopathic hyperaldosteronism: 12‐month results from a proof‐of‐principle trial

The impact of superselective adrenal artery embolization on renal function in patients with primary aldosteronism: a prospective cohort study

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