Percutaneous Microwave Ablation for Aldosterone-Producing Adenoma

Area of Science:

• Endocrinology
• Interventional Radiology

Background:

• Aldosterone-producing adenomas (APAs) cause primary aldosteronism, leading to hypertension and hypokalemia.
• Current treatments include surgery (adrenalectomy) or medication, with varying success rates.

Purpose of the Study:

• To evaluate the efficacy and safety of CT-guided percutaneous microwave ablation (MWA) for treating APAs.
• To compare outcomes of MWA with established standards for primary aldosteronism treatment.

Main Methods:

• Thirty-five patients with APAs underwent CT-guided percutaneous MWA.
• Pre- and post-procedural assessments included aldosterone-to-renin ratio, potassium levels, blood pressure, and medication use.
• Outcomes were assessed using the Primary Aldosteronism Surgical Outcome (PASO) standards.

Main Results:

• All patients achieved correction of hypokalemia.
• Significant reductions in blood pressure and antihypertensive medication requirements were observed post-MWA.
• Biochemical success rates were high (89% complete success), with substantial clinical success (37% complete, 60% partial).
• Hypertensive crisis occurred in 20% but was managed effectively.

Conclusions:

• CT-guided percutaneous MWA is a safe and effective treatment modality for APAs.
• MWA demonstrates biochemical and clinical outcomes comparable to adrenalectomy based on PASO standards.
• This minimally invasive approach offers a viable alternative for APA management.