A Comparative Study of the Clinical Efficacy of Superselective Adrenal Artery Embolization for Patients with Primary Aldosteronism

BACKGROUND: Superselective adrenal artery embolization (SAAE) is a potential treatment option for patients with primary aldosteronism (PA). METHODS: This retrospective study aimed to compare the clinical efficacy and impact on cardiorenal organs of SAAE with mineralocorticoid receptor antagonists (MRA) and adrenalectomy (ADX) in patients with PA. After a median follow-up of 19 (12.5-26.5) months, 148 patients with PA were included in the study. The study cohorts consisted of 58, 53, and 37 patients treated with SAAE, MRA, and ADX, respectively. RESULTS: During follow-up, SAAE achieved a significantly greater level of complete clinical success in the treatment of PA compared to MRA (P < 0.05). Within the SAAE group (n = 58), 19 (32.8%) and 26 (44.8%) patients achieved complete and partial clinical success, respectively. However, there were no significant differences in the prognostic parameters of the cardiorenal organs between the two groups. In the comparison of patients with UPA treated with SAAE (n = 35) and ADX (n = 37), there was no significant difference in clinical efficacy between the two groups. CONCLUSIONS: The findings of this study suggest that for patients with PA who are not suitable for ADX, SAAE is a viable treatment option that significantly improves clinical outcomes compared to MRA treatment.