Diagnostic Radiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Department of Diabetes, Metabolism and Endocrinology, Tohoku University Hospital, Sendai, Miyagi, Japan.
Cardiovasc Intervent Radiol. 2023 Dec;46(12):1666-1673. doi: 10.1007/s00270-023-03584-x. Epub 2023 Nov 16.
To describe a novel technique of transvenous radiofrequency catheter ablation of an aldosterone-producing adenoma (APA) of the left adrenal gland using the GOS System (Japan Lifeline, Tokyo, Japan). Using the GOS system, a flexible radiofrequency tip catheter can be inserted into the adrenal central and tributary veins, the drainers for functional tumors.
An APA at the left adrenal gland, which was diagnosed by segmental adrenal venous sampling following administration of 0.25 mg cosyntropin, was ablated using the GOS catheter inserted into adrenal tributary veins via a right femoral vein 7-Fr sheath. The effect of radiofrequency ablation on APA was assessed using the international consensus on surgical outcomes for unilateral primary aldosteronism (PA).
No device-related complications were observed. The patient was deeply sedated under blood pressure and heart rate control with continuous administration of β-blockers. Then, the tumor and surrounding adrenal gland were cauterized at 7000 J two times each in sequence. The output time was 7-11 min for each ablation and 80 min in total. For blood pressure and pulse rate control, esmolol hydrochloride and phentolamine mesylate were used. The contrast enhancement of APA disappeared on dynamic CT immediately after the procedure. PA was biochemically cured until 12 months after the procedure.
Using the radiofrequency device with the GOS catheter and system is a method for cauterizing adrenal tumors from blood vessels. This approach resulted in a marked reduction in aldosterone concentrations and a complete biochemical cure of PA over the observation period.
描述一种使用 GOS 系统（日本生命线，东京，日本）经静脉射频导管消融左侧肾上腺产生醛固酮的腺瘤（APA）的新方法。使用 GOS 系统，可将柔性射频尖端导管插入肾上腺中央和支流静脉中，这些静脉是功能性肿瘤的引流器。
通过给予 0.25mg 促皮质素后进行节段性肾上腺静脉取样，诊断出左肾上腺的 APA，使用经右侧股静脉 7Fr 鞘插入肾上腺支流静脉的 GOS 导管进行消融。使用单侧原发性醛固酮增多症（PA）手术治疗的国际共识评估射频消融对 APA 的影响。
未观察到与器械相关的并发症。在持续给予β受体阻滞剂以控制血压和心率的情况下，患者处于深度镇静状态。然后，在两次 7000J 下顺序对肿瘤和周围肾上腺进行烧灼，每次消融的输出时间为 7-11 分钟，总时间为 80 分钟。为了控制血压和脉搏率，使用盐酸艾司洛尔和甲磺酸酚妥拉明。术后即刻动态 CT 显示 APA 的增强对比度消失。PA 在术后 12 个月内实现了生化治愈。
使用带有 GOS 导管和系统的射频设备是一种从血管中烧灼肾上腺肿瘤的方法。这种方法导致醛固酮浓度显著降低，PA 在观察期内完全实现生化治愈。
