Efficacy and Safety of Adrenal Artery Embolization for Idiopathic Hyperaldosteronism: A Systematic Review & Meta-Analysis.

IF 3.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CardioVascular and Interventional Radiology Pub Date : 2026-09-29 DOI:10.1007/s00270-026-04641-x

Eduardo Germano Teixeira, Rafael Duran, Filipe Barra, Iago Maia Hezel, Viviane Pinheiro de Oliveira Germano, Marco Rivera, Bernard Campos Araruna Giancristoforo

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引用次数: 0

Abstract

Purpose: To evaluate the efficacy and safety of adrenal artery embolization for idiopathic hyperaldosteronism.

Materials and methods: PubMed, Embase, and Cochrane databases were searched through June 2026. Studies reporting clinical outcomes after adrenal artery embolization for idiopathic hyperaldosteronism were included. Outcomes comprised 24-h ambulatory and home blood pressure, plasma aldosterone and renin, aldosterone-to-renin ratio, serum potassium and cortisol, and safety. Random-effects models and leave-one-out analyses were used.

Results: Four studies including 284 patients allocated to or undergoing adrenal artery embolization were included: outcome-specific sample sizes varied according to data availability. Adrenal artery embolization reduced 24-h systolic blood pressure by 15.31 mmHg and diastolic blood pressure by 10.49 mmHg. Plasma aldosterone decreased by 68.18 pg/mL, the aldosterone-to-renin ratio by 49.03, and serum potassium increased by 0.60 mmol/L. Serum cortisol did not significantly change. Pain and fever occurred in 82.41% (178/216) and 18.98% (41/216) of patients across three studies. Major adverse events occurred in 4.58% (13/284): four strokes (one fatal hemorrhagic, adjudicated unrelated), five hypertensive or severe-hypertension events, one myocardial infarction, one new-onset heart failure, one ventricular tachycardia, and one hypotensive event requiring vasopressors-only three within 1 month.

Conclusion: Adrenal artery embolization showed preliminary associations with improved blood pressure and biochemical outcomes without a significant change in serum cortisol. Evidence was predominantly uncontrolled, serious adverse events occurred, and superiority over optimized medical therapy was not established. Randomized trials with standardized techniques and long-term clinical outcomes are required.

Level of evidence: Level IV, Systematic Review/Meta-Analysis of predominantly single-arm studies.

查看原文本刊更多论文

肾上腺动脉栓塞治疗特发性高醛固酮增多症的疗效和安全性：一项系统综述和荟萃分析。

目的：评价肾上腺动脉栓塞治疗特发性高醛固酮增多症的疗效和安全性。材料和方法：检索PubMed、Embase和Cochrane数据库至2026年6月。研究报告了特发性高醛固酮增多症的肾上腺动脉栓塞后的临床结果。结果包括24小时动态和家庭血压、血浆醛固酮和肾素、醛固酮和肾素比、血清钾和皮质醇以及安全性。采用随机效应模型和留一分析。结果：纳入4项研究，包括284例分配或接受肾上腺动脉栓塞的患者：结果特异性样本量根据数据可用性而变化。肾上腺动脉栓塞使24小时收缩压降低15.31 mmHg，舒张压降低10.49 mmHg。血浆醛固酮降低68.18 pg/mL，醛固酮与肾素比值降低49.03，血清钾升高0.60 mmol/L。血清皮质醇无明显变化。在三项研究中，分别有82.41%（178/216）和18.98%（41/216）的患者出现疼痛和发热。4.58%（13/284）的患者发生了主要不良事件：4例中风（1例致命出血，判定无关），5例高血压或严重高血压事件，1例心肌梗死，1例新发心力衰竭，1例室性心动过速，1例需要使用血管加压药物的低血压事件——1个月内仅有3例。结论：肾上腺动脉栓塞与血压和生化结果的改善初步相关，而血清皮质醇没有显著变化。证据主要是不受控制的，发生了严重的不良事件，并没有确定优于优化药物治疗的优势。需要标准化技术和长期临床结果的随机试验。证据等级：IV级，主要为单臂研究的系统评价/ meta分析。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CardioVascular and Interventional Radiology 医学-核医学

CiteScore

5.50

自引率

13.80%

发文量

306

审稿时长

3-8 weeks

期刊介绍： CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.