Case report: Percutaneous adrenal arterial embolization cures resistant hypertension

Area of Science:

• Endocrinology
• Interventional Radiology

Background:

• Primary aldosteronism is a frequent cause of difficult-to-treat hypertension.
• Treatment options include surgery or medication, but adherence and efficacy can be challenging.
• Superselective adrenal arterial embolization presents a minimally invasive alternative.

Observation:

• A 39-year-old male with a 5-year history of primary aldosteronism and resistant hypertension refused adrenalectomy.
• Despite adequate medical therapy, the patient experienced hypokalemia, poor blood pressure control, left ventricular hypertrophy, and renal dysfunction.
• Aldosterone-producing adenoma in the left adrenal gland was confirmed.

Findings:

• Superselective embolization of the left middle adrenal artery supplying the adenoma was performed using 2 ml of ethanol.
• This procedure normalized blood pressure for 3 months and reversed left ventricular hypertrophy.
• The patient's symptoms and complications significantly improved.

Implications:

• Superselective adrenal arterial embolization is a viable alternative for patients with aldosterone-producing adenoma who decline surgery.
• This interventional technique may offer a less invasive approach to managing primary aldosteronism.
• Further research is warranted to establish long-term efficacy and safety profiles.