Clinical and Biochemical Outcomes of Super-Selective Adrenal Artery Embolization in Primary Aldosteronism: A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis study evaluated the clinical and biochemical efficacy of super-selective adrenal artery embolization (SAAE) in patients with primary aldosteronism (PA). The primary outcome was the change in office blood pressure, while secondary outcomes included changes in plasma aldosterone and serum potassium levels following the procedure. A systematic search of Embase, PubMed, Ovid, Web of Science, China National Knowledge Infrastructure, Wanfang, and SinoMed was conducted through December 14, 2024. Seventeen studies involving 650 patients (aged 28–65 years) with a median follow-up of 6 months were included. Meta-analysis, subgroup analysis, publication bias assessment, and sensitivity analysis were performed using RevMan 5.3 and R 4.2.3. The results showed that SAAE significantly reduced systolic (MD = −19.84 mmHg, 95% CI: −22.87 to −16.82 mmHg) and diastolic blood pressure (MD = −10.62 mmHg, 95% CI: −12.61 to −8.64 mmHg), lowered plasma aldosterone levels (MD = −90.99 pg/mL, 95% CI: −119.36 to −62.63 pg/mL), and increased serum potassium levels (MD = 0.59 mmol/L, 95% CI: 0.49–0.70 mmol/L). Subgroup analyses confirmed benefits in patients with both idiopathic hyperaldosteronism and aldosterone-producing adenoma. These findings support SAAE as an effective treatment for improving clinical outcomes and correcting biochemical abnormalities in PA.