Transcatheter arterial ablation of aldosteronomas with high-concentration ethanol: Preliminary and long-term results

OBJECTIVE. The purpose of this study was to evaluate the efficacy of transcatheter arterial ablation (TAA) of aldosteronomas with high-concentration ethanol (HCE). MATERIALS AND METHODS. From August 1992 to August 1995, 18 patients with unilateral aldosteronoma, three men and 15 women, 28-65 years old, were treated by TAA with HCE. A single dose (0.2-7.0 mi) of HCE was selectively infused into the feeding arterial branches of the aldosteronoma using a microcatheter and the coaxial technique, The 18 patients underwent 31 TAA procedures, RESULTS. Ablation of the aldosteronoma was monitored by measuring plasma levels of aldosterone and was successful in 15 (83%) of 18 patients. The remaining three patients underwent surgery because results of TAA were insufficient. The destructive effect of ablation by HCE has persisted for 7-38 months (mean, 20 months) in 14 patients, Although one patient had recurrence of symptoms 15 months after the initial TAA, normalization of plasma levels of aldosterone continued for 3 months after TAA was repeated, No severe complications occurred in any of the 18 patients. However, back pain (18 of 18), slight fever (nine of 18), pleural effusion (two of 18), and labile changes in blood pressure (one of 18) were noted in patients 1-7 days after the procedure. CONCLUSION, TAA of aldosteronoma with HCE is an alternative to open adrenalectomy.