Transvenous Radiofrequency Catheter Ablation for an Aldosterone-Producing Tumor of the Left Adrenal Gland: A First in Human Case Report

Transvenous Radiofrequency Catheter Ablation for an Aldosterone-Producing Tumor of the Left Adrenal Gland: A First in Human Case Report

Purpose To describe a novel technique of transvenous radiofrequency catheter ablation of an aldosterone-producing adenoma (APA) of the left adrenal gland using the GOS System (Japan Lifeline, Tokyo, Japan). Using the GOS system, a flexible radiofrequency tip catheter can be inserted into the adrenal...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology Vol. 46; no. 12; pp. 1666 - 1673
Main Authors: Oguro, Sota, Ota, Hideki, Yanagaki, Satoru, Kawabata, Masahiro, Kamada, Hiroki, Omata, Kei, Tezuka, Yuta, Ono, Yoshikiyo, Morimoto, Ryo, Satoh, Fumitoshi, Toyama, Hiroaki, Tanimoto, Kouta, Konno, Daisuke, Yamauchi, Masanori, Niwa, Yuki, Miyamoto, Hisao, Mori, Kenji, Tanaka, Tetsuhiro, Ishihata, Hiroshi, Takase, Kei
Format: Journal Article
Language:English
Published: New York Springer US 01-12-2023
Springer Nature B.V
Subjects:
Ablation
Adrenal glands
Aldosterone
Blood pressure
Blood vessels
Cardiology
Catheters
Complications
Cutting Edge
Endocrine disorders
Heart rate
Imaging
Medical instruments
Medicine
Medicine & Public Health
Nuclear Medicine
Phentolamine
Radio frequency
Radiofrequency ablation
Radiology
Sheaths
Tumors
Ultrasound
Veins
Veins & arteries
Venous Interventions
Japan
Segmental adrenal vein sampling
Transvenous catheter radiofrequency ablation
Aldosterone-producing adrenal tumor
First in human
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Summary:Purpose To describe a novel technique of transvenous radiofrequency catheter ablation of an aldosterone-producing adenoma (APA) of the left adrenal gland using the GOS System (Japan Lifeline, Tokyo, Japan). Using the GOS system, a flexible radiofrequency tip catheter can be inserted into the adrenal central and tributary veins, the drainers for functional tumors. Materials and methods An APA at the left adrenal gland, which was diagnosed by segmental adrenal venous sampling following administration of 0.25 mg cosyntropin, was ablated using the GOS catheter inserted into adrenal tributary veins via a right femoral vein 7-Fr sheath. The effect of radiofrequency ablation on APA was assessed using the international consensus on surgical outcomes for unilateral primary aldosteronism (PA). Results No device-related complications were observed. The patient was deeply sedated under blood pressure and heart rate control with continuous administration of β-blockers. Then, the tumor and surrounding adrenal gland were cauterized at 7000 J two times each in sequence. The output time was 7−11 min for each ablation and 80 min in total. For blood pressure and pulse rate control, esmolol hydrochloride and phentolamine mesylate were used. The contrast enhancement of APA disappeared on dynamic CT immediately after the procedure. PA was biochemically cured until 12 months after the procedure. Conclusion Using the radiofrequency device with the GOS catheter and system is a method for cauterizing adrenal tumors from blood vessels. This approach resulted in a marked reduction in aldosterone concentrations and a complete biochemical cure of PA over the observation period. Graphical Abstract
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-023-03584-x