Language
English
Publication Date
1-1-2026
Journal
International Journal of Endocrinology
DOI
10.1155/ije/7534774
PMID
42487664
PMCID
PMC13389810
PubMedCentral® Posted Date
7-22-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Background: Primary aldosteronism (PA) is a leading cause of secondary hypertension associated with increased cardiovascular and cerebrovascular risk. Superselective adrenal artery embolization (SAAE) has emerged as a minimally invasive alternative to adrenalectomy and mineralocorticoid receptor antagonists (MRAs). This systematic review and meta-analysis evaluates the efficacy and safety of SAAE in PA management.
Methods: We searched PubMed, Web of Science, Embase, and Cochrane Library through June 2026 for studies enrolling patients with PA treated by SAAE. Outcomes of interest were changes in blood pressure (BP), biochemical markers (serum potassium, aldosterone, renin activity, and aldosterone-to-renin ratio), clinical and biochemical response rates, daily defined dose change, and adverse events. Data were pooled using a random-effects model.
Results: Nineteen studies comprising 1242 patients undergoing SAAE met inclusion criteria. SAAE achieved substantial BP reductions: office systolic BP -19.71 mmHg (p < 0.001), office diastolic BP -10.91 mmHg (p < 0.001), home systolic BP -18.58 mmHg (p < 0.001), and 24-h ambulatory systolic BP -14.57 mmHg (p < 0.001). Serum potassium increased +0.34 mmol/L (p < 0.001), aldosterone declined -46.72 ng/dL (p < 0.001), and ARR decreased -32.64 (p < 0.001). Complete clinical response occurred in 27% and partial response in 43%; complete biochemical success was achieved in 48% with partial success in 16%. Antihypertensive burden decreased (-0.52 daily defined dose; p < 0.001). Adverse events were predominantly minor (postprocedural pain 37.17%, low-grade fever 8.55%); serious complications were uncommon (< 1%).
Conclusions: SAAE is an effective and somewhat safe treatment for PA that achieves meaningful BP control, biochemical normalization, and reduced medication burden. It represents a valuable option for patients ineligible for or intolerant of surgery or MRAs.
Keywords
primary aldosteronism (PA), safety and efficacy, superselective adrenal artery embolization (SAAE)
Published Open-Access
yes
Recommended Citation
Darmiani, Kimia; Zare, Mehrad; Mohebbi, Alisa; et al., "Beyond Drugs and Surgery: Superselective Adrenal Artery Embolization Redefines Primary Aldosteronism Management-A Systematic Review and Meta-Analysis" (2026). Faculty, Staff and Students Publications. 7841.
https://digitalcommons.library.tmc.edu/baylor_docs/7841