Bilateral superselective adrenal artery embolization for bilateral primary aldosteronism: a novel approach in an efficacy and safety proof-of-principle trial

• Published in: Hypertension research 2025, Vol.48 (1), p.189-199
• Main Authors: Li, Xin, Feng, Rui, Xiang, Rui, Tao, Li, Zhao, Yong-peng, Tang, Ping, Zuo, Zhong, Gao, Dian-Sa, Lou, Qin, Pu, Peng, Chen, Yue-Ming, Chen, Jie, Lv, Feng-Jie, Wang, Ling, Zhao, Hong, Shi, Qiu-Yue, He, Yu-Tian, Khan, Nouman Ali, Chang, Jing, Mao, Min
• Format: Article
• Language: English
• Subjects: Geriatrics/Gerontology; Health Promotion and Disease Prevention; Internal Medicine; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Public Health
• ISSN: 0916-9636; 1348-4214; 1348-4214
• DOI: 10.1038/s41440-024-01881-7

Superselective adrenal artery embolization (SAAE) offers a novel approach for treating primary aldosteronism (PA). In this study, we aimed to assess the efficacy and safety of SAAE for the treatment of PA based on the lateralization results obtained from adrenal vein sampling (AVS).In this prospective study, we enrolled 40 patients with PA who underwent SAAE. The patients were categorized into two groups, unilateral PA and bilateral PA, based on AVS results. Clinical parameters and biochemical markers were assessed at 3 and 12 months postoperatively. The primary outcomes were changes in blood pressure and defined daily dose (DDD) of antihypertensive medications compared to baseline. Thirty-eight patients achieved technical success, with favorable clinical and biochemical efficacy rates. At three months postoperatively, the clinical efficacy rates were 79.2% and 78.6% for the UPA and BPA groups, respectively. At 12 months, the rates were 83.3% and 71.4%, respectively. Both groups exhibited a significant decrease in average blood pressure at 3 and 12 months compared with baseline ( P