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

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. These authors contributed equally: Sen Liu, Xinquan Wang.