Clinical Outcomes following Percutaneous Radiofrequency Ablation of Unilateral Aldosterone-Producing Adenoma: Comparison with Adrenalectomy.

Autor:	Sarwar A; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, WCC 308-B, 1 Deaconess Road, Boston, MA 02215. Electronic address: asarwar@bidmc.harvard.edu., Brook OR; Department of Medicine Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Vaidya A; Department of Medicine Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Sacks AC; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Sacks BA; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, WCC 308-B, 1 Deaconess Road, Boston, MA 02215., Goldberg SN; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, WCC 308-B, 1 Deaconess Road, Boston, MA 02215., Ahmed M; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, WCC 308-B, 1 Deaconess Road, Boston, MA 02215., Faintuch S; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, WCC 308-B, 1 Deaconess Road, Boston, MA 02215.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2016 Jul; Vol. 27 (7), pp. 961-7. Date of Electronic Publication: 2016 May 27.
DOI:	10.1016/j.jvir.2016.03.042
Abstrakt:	Purpose: To compare adrenal radiofrequency (RF) ablation with adrenalectomy in treating unilateral aldosterone-producing adenoma (APA). Materials and Methods: Between April 2008 and September 2013, 44 patients with adrenal venous sampling-confirmed (lateralization index ≥ 4) unilateral APA underwent adrenal RF ablation (12/44 [27%]) or adrenalectomy (32/44 [73%]). Outcomes of adrenal RF ablation (patient age, 51 y ± 11; 4/12 men) were compared with adrenalectomy (patient age, 50 y ± 11; 19/32 men). Blood pressure (145/94 mm Hg ± 19/13 vs 144/89 mm Hg ± 10/8, P = .92), number of antihypertensives (3.0 ± 1.3 vs 2.7 ± 0.89, P = .38), and serum potassium (3.2 mEq/L ± 0.6 vs 3.5 mEq/L ± 0.6, P = .65) of patients were similar before treatment. Results: RF ablation and adrenalectomy resulted in normokalemia (RF ablation, 4.2 mEq/L ± 0.1, P = .0004; adrenalectomy, 4.3 mEq/L ± 0.6, P < .0001) and normotension (RF ablation, 129/81 mm Hg ± 11/11, P = .02/P = .001; adrenalectomy, 128/85 mm Hg ± 13/12, P < .0001/P = .07) in all patients. Proportions of RF ablation and adrenalectomy patients cured of hypertension (2/12 [17%] vs 12/32 [38%], P = .28) or requiring fewer antihypertensives (7/12 [58%] vs 13/32 [40%], P = .29) were similar. RF ablation patients had a shorter length of stay (0.6 d ± 0.8 [range, 0-2 d] vs 1.7 d ± 1.4 [range, 0-7 d]; P = .01) and less intraoperative blood loss (1.2 mL ± 3 vs 40 mL ±85; P = .01). Procedural complications occurred in 5/32 (15%) adrenalectomy patients (2 major, 3 minor) and in 0/12 RF ablation patients. Conclusions: RF ablation to treat APA can achieve similar clinical outcomes as adrenalectomy and results in shorter hospital stays. Larger, prospective trials are needed to validate these results. (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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