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同侧超选择性肾上腺动脉造影及肾上腺静脉造影在原发性醛固酮增多症患者肾上腺动脉栓塞术中的应用价值

The application value of ipsilateral superselective adrenal arteriography and adrenal venography in patients with primary aldosteronism undergoing adrenal artery embolization.

作者信息

Liu Sen, Wang Xinquan, Wang Peijian

机构信息

Department of Cardiology, Department of Clinical Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, Sichuan, China.

Key Laboratory of Aging and Vascular Homeostasis at Chengdu Medical College of Sichuan Province, Chengdu, 610500, Sichuan, China.

出版信息

Hypertens Res. 2025 Apr;48(4):1422-1427. doi: 10.1038/s41440-025-02126-x. Epub 2025 Jan 23.

Abstract

Superselective adrenal artery embolization (SAAE) has increasingly emerged as an alternative treatment for primary aldosteronism (PA) patients who either unwilling or unable to undergo surgical adrenalectomy, and cannot tolerate or refuse to mineralocorticoid receptor antagonists (MRAs). Although SAAE has been applied in PA treatment for over two decades, its safety and efficacy are still uncertain due to absence of multi-center, randomized controlled trials, hindering its widespread clinical adoption. Currently, only a few centers could perform this procedure proficiently, leading to variability in technical protocols and clinical outcomes across different institutions. During SAAE procedure, it is crucial to determine the target adrenal artery, while misidentification of the artery could lead to severe complications. To promote the safe and effective performance of SAAE, we aim to explore the application value of ipsilateral superselective adrenal arteriography and adrenal venography during the SAAE procedure. The application value of ipsilateral superselective adrenal arteriography and adrenal venography in patients with primary aldosteronism undergoing adrenal artery embolization. SAAE superselective adrenal artery embolization, AVS adrenal venous sampling.

摘要

超选择性肾上腺动脉栓塞术(SAAE)已越来越多地成为原发性醛固酮增多症(PA)患者的一种替代治疗方法,这些患者要么不愿意要么无法接受肾上腺切除术,且不能耐受或拒绝使用盐皮质激素受体拮抗剂(MRA)。尽管SAAE已应用于PA治疗二十多年,但由于缺乏多中心随机对照试验,其安全性和有效性仍不确定,这阻碍了其在临床上的广泛应用。目前,只有少数中心能够熟练进行该手术,导致不同机构的技术方案和临床结果存在差异。在SAAE手术过程中,确定目标肾上腺动脉至关重要,而动脉误认可能导致严重并发症。为促进SAAE的安全有效实施,我们旨在探讨同侧超选择性肾上腺动脉造影和肾上腺静脉造影在SAAE手术中的应用价值。同侧超选择性肾上腺动脉造影和肾上腺静脉造影在接受肾上腺动脉栓塞术的原发性醛固酮增多症患者中的应用价值。SAAE超选择性肾上腺动脉栓塞术,AVS肾上腺静脉采样

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