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Bilateral superselective adrenal artery embolization for bilateral primary aldosteronism: a novel approach in an efficacy and safety proof-of-principle trial
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 prospecti...
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| Published in: | Hypertension research 2025, Vol.48 (1), p.189-199 |
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| creator | 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 |
| description | 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
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| doi_str_mv | 10.1038/s41440-024-01881-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3103449173</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3103449173</sourcerecordid><originalsourceid>FETCH-LOGICAL-c228t-642dcb279082fc7d325ac594a27945fa89403c7a9b3154c76716c15332e52093</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhS1URC-FF2CBvGRj8F_imB1U_EmV2HRvTZwxuHLiYCeVyrvwrrjcS5eVLFkaf-dofA4hrwR_K7ga3lUttOaMS824GAbBzBNyEEoPTEuhz8iBW9Ez26v-nDyv9YZzOXRWPCPnyspeGM4P5M_HmGDDAonWfcVSMaHf4i1SmAoubQylPd9RnMec4m_YYl5oyIWOD8K1xBkaAmnKtY3yEuv8ngJd8i02g3UtGfxPGhcKC8UQogff8GWiFQJud80h58DaaVaLj2tCupUI6QV5GiBVfHm6L8j150_Xl1_Z1fcv3y4_XDEv5bCxXsvJj9JYPsjgzaRkB76zGtpIdwEGq7nyBuyoRKe96Y3oveiUkthJbtUFeXO0bXv82rFubo7VY0qwYN6rUy1ura0wqqHyiPqSay0Y3On3TnB334o7tuJaK-5fK8400euT_z7OOD1I_tfQAHUE6n0AP7C4m7yXln59zPYvT3Sa7A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3103449173</pqid></control><display><type>article</type><title>Bilateral superselective adrenal artery embolization for bilateral primary aldosteronism: a novel approach in an efficacy and safety proof-of-principle trial</title><source>Nexis UK</source><source>Springer Link</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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
< 0.001), and there was also a notable reduction in DDD (
P
< 0.05). At three months, the biochemical efficacy rates were 61.9% and 58.3% in the UPA and BPA groups, respectively. Due to loss to follow-up, biochemical indicators were not assessed at 12 months postoperatively. No severe adverse reactions occurred during or after SAAE. Patients with both UPA and BPA can benefit from SAAE. The superiority of bilateral adrenal artery embolization in the treatment of BPA over unilateral adrenal artery embolization requires further investigation.</description><identifier>ISSN: 0916-9636</identifier><identifier>ISSN: 1348-4214</identifier><identifier>EISSN: 1348-4214</identifier><identifier>DOI: 10.1038/s41440-024-01881-7</identifier><identifier>PMID: 39261700</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Adrenal Glands - blood supply ; Adult ; Aged ; Aldosterone - blood ; Blood Pressure ; Embolization, Therapeutic - methods ; Female ; Geriatrics/Gerontology ; Health Promotion and Disease Prevention ; Humans ; Hyperaldosteronism - therapy ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Obstetrics/Perinatology/Midwifery ; Prospective Studies ; Public Health ; Treatment Outcome</subject><ispartof>Hypertension research, 2025, Vol.48 (1), p.189-199</ispartof><rights>The Author(s), under exclusive licence to The Japanese Society of Hypertension 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c228t-642dcb279082fc7d325ac594a27945fa89403c7a9b3154c76716c15332e52093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39261700$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Xin</creatorcontrib><creatorcontrib>Feng, Rui</creatorcontrib><creatorcontrib>Xiang, Rui</creatorcontrib><creatorcontrib>Tao, Li</creatorcontrib><creatorcontrib>Zhao, Yong-peng</creatorcontrib><creatorcontrib>Tang, Ping</creatorcontrib><creatorcontrib>Zuo, Zhong</creatorcontrib><creatorcontrib>Gao, Dian-Sa</creatorcontrib><creatorcontrib>Lou, Qin</creatorcontrib><creatorcontrib>Pu, Peng</creatorcontrib><creatorcontrib>Chen, Yue-Ming</creatorcontrib><creatorcontrib>Chen, Jie</creatorcontrib><creatorcontrib>Lv, Feng-Jie</creatorcontrib><creatorcontrib>Wang, Ling</creatorcontrib><creatorcontrib>Zhao, Hong</creatorcontrib><creatorcontrib>Shi, Qiu-Yue</creatorcontrib><creatorcontrib>He, Yu-Tian</creatorcontrib><creatorcontrib>Khan, Nouman Ali</creatorcontrib><creatorcontrib>Chang, Jing</creatorcontrib><creatorcontrib>Mao, Min</creatorcontrib><title>Bilateral superselective adrenal artery embolization for bilateral primary aldosteronism: a novel approach in an efficacy and safety proof-of-principle trial</title><title>Hypertension research</title><addtitle>Hypertens Res</addtitle><addtitle>Hypertens Res</addtitle><description>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
< 0.001), and there was also a notable reduction in DDD (
P
< 0.05). At three months, the biochemical efficacy rates were 61.9% and 58.3% in the UPA and BPA groups, respectively. Due to loss to follow-up, biochemical indicators were not assessed at 12 months postoperatively. No severe adverse reactions occurred during or after SAAE. Patients with both UPA and BPA can benefit from SAAE. The superiority of bilateral adrenal artery embolization in the treatment of BPA over unilateral adrenal artery embolization requires further investigation.</description><subject>Adrenal Glands - blood supply</subject><subject>Adult</subject><subject>Aged</subject><subject>Aldosterone - blood</subject><subject>Blood Pressure</subject><subject>Embolization, Therapeutic - methods</subject><subject>Female</subject><subject>Geriatrics/Gerontology</subject><subject>Health Promotion and Disease Prevention</subject><subject>Humans</subject><subject>Hyperaldosteronism - therapy</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Prospective Studies</subject><subject>Public Health</subject><subject>Treatment Outcome</subject><issn>0916-9636</issn><issn>1348-4214</issn><issn>1348-4214</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1TAQhS1URC-FF2CBvGRj8F_imB1U_EmV2HRvTZwxuHLiYCeVyrvwrrjcS5eVLFkaf-dofA4hrwR_K7ga3lUttOaMS824GAbBzBNyEEoPTEuhz8iBW9Ez26v-nDyv9YZzOXRWPCPnyspeGM4P5M_HmGDDAonWfcVSMaHf4i1SmAoubQylPd9RnMec4m_YYl5oyIWOD8K1xBkaAmnKtY3yEuv8ngJd8i02g3UtGfxPGhcKC8UQogff8GWiFQJud80h58DaaVaLj2tCupUI6QV5GiBVfHm6L8j150_Xl1_Z1fcv3y4_XDEv5bCxXsvJj9JYPsjgzaRkB76zGtpIdwEGq7nyBuyoRKe96Y3oveiUkthJbtUFeXO0bXv82rFubo7VY0qwYN6rUy1ura0wqqHyiPqSay0Y3On3TnB334o7tuJaK-5fK8400euT_z7OOD1I_tfQAHUE6n0AP7C4m7yXln59zPYvT3Sa7A</recordid><startdate>2025</startdate><enddate>2025</enddate><creator>Li, Xin</creator><creator>Feng, Rui</creator><creator>Xiang, Rui</creator><creator>Tao, Li</creator><creator>Zhao, Yong-peng</creator><creator>Tang, Ping</creator><creator>Zuo, Zhong</creator><creator>Gao, Dian-Sa</creator><creator>Lou, Qin</creator><creator>Pu, Peng</creator><creator>Chen, Yue-Ming</creator><creator>Chen, Jie</creator><creator>Lv, Feng-Jie</creator><creator>Wang, Ling</creator><creator>Zhao, Hong</creator><creator>Shi, Qiu-Yue</creator><creator>He, Yu-Tian</creator><creator>Khan, Nouman Ali</creator><creator>Chang, Jing</creator><creator>Mao, Min</creator><general>Springer Nature Singapore</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2025</creationdate><title>Bilateral superselective adrenal artery embolization for bilateral primary aldosteronism: a novel approach in an efficacy and safety proof-of-principle trial</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c228t-642dcb279082fc7d325ac594a27945fa89403c7a9b3154c76716c15332e52093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adrenal Glands - blood supply</topic><topic>Adult</topic><topic>Aged</topic><topic>Aldosterone - blood</topic><topic>Blood Pressure</topic><topic>Embolization, Therapeutic - methods</topic><topic>Female</topic><topic>Geriatrics/Gerontology</topic><topic>Health Promotion and Disease Prevention</topic><topic>Humans</topic><topic>Hyperaldosteronism - therapy</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Prospective Studies</topic><topic>Public Health</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Xin</creatorcontrib><creatorcontrib>Feng, Rui</creatorcontrib><creatorcontrib>Xiang, Rui</creatorcontrib><creatorcontrib>Tao, Li</creatorcontrib><creatorcontrib>Zhao, Yong-peng</creatorcontrib><creatorcontrib>Tang, Ping</creatorcontrib><creatorcontrib>Zuo, Zhong</creatorcontrib><creatorcontrib>Gao, Dian-Sa</creatorcontrib><creatorcontrib>Lou, Qin</creatorcontrib><creatorcontrib>Pu, Peng</creatorcontrib><creatorcontrib>Chen, Yue-Ming</creatorcontrib><creatorcontrib>Chen, Jie</creatorcontrib><creatorcontrib>Lv, Feng-Jie</creatorcontrib><creatorcontrib>Wang, Ling</creatorcontrib><creatorcontrib>Zhao, Hong</creatorcontrib><creatorcontrib>Shi, Qiu-Yue</creatorcontrib><creatorcontrib>He, Yu-Tian</creatorcontrib><creatorcontrib>Khan, Nouman Ali</creatorcontrib><creatorcontrib>Chang, Jing</creatorcontrib><creatorcontrib>Mao, Min</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Xin</au><au>Feng, Rui</au><au>Xiang, Rui</au><au>Tao, Li</au><au>Zhao, Yong-peng</au><au>Tang, Ping</au><au>Zuo, Zhong</au><au>Gao, Dian-Sa</au><au>Lou, Qin</au><au>Pu, Peng</au><au>Chen, Yue-Ming</au><au>Chen, Jie</au><au>Lv, Feng-Jie</au><au>Wang, Ling</au><au>Zhao, Hong</au><au>Shi, Qiu-Yue</au><au>He, Yu-Tian</au><au>Khan, Nouman Ali</au><au>Chang, Jing</au><au>Mao, Min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bilateral superselective adrenal artery embolization for bilateral primary aldosteronism: a novel approach in an efficacy and safety proof-of-principle trial</atitle><jtitle>Hypertension research</jtitle><stitle>Hypertens Res</stitle><addtitle>Hypertens Res</addtitle><date>2025</date><risdate>2025</risdate><volume>48</volume><issue>1</issue><spage>189</spage><epage>199</epage><pages>189-199</pages><issn>0916-9636</issn><issn>1348-4214</issn><eissn>1348-4214</eissn><abstract>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
< 0.001), and there was also a notable reduction in DDD (
P
< 0.05). At three months, the biochemical efficacy rates were 61.9% and 58.3% in the UPA and BPA groups, respectively. Due to loss to follow-up, biochemical indicators were not assessed at 12 months postoperatively. No severe adverse reactions occurred during or after SAAE. Patients with both UPA and BPA can benefit from SAAE. The superiority of bilateral adrenal artery embolization in the treatment of BPA over unilateral adrenal artery embolization requires further investigation.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>39261700</pmid><doi>10.1038/s41440-024-01881-7</doi><tpages>11</tpages></addata></record> |
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| subjects | Adrenal Glands - blood supply Adult Aged Aldosterone - blood Blood Pressure Embolization, Therapeutic - methods Female Geriatrics/Gerontology Health Promotion and Disease Prevention Humans Hyperaldosteronism - therapy Internal Medicine Male Medicine Medicine & Public Health Middle Aged Obstetrics/Perinatology/Midwifery Prospective Studies Public Health Treatment Outcome |
| title | Bilateral superselective adrenal artery embolization for bilateral primary aldosteronism: a novel approach in an efficacy and safety proof-of-principle trial |
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