Adrenal gland-sparing transcatheter embolisation of an aldosteronoma for the treatment of refractory hypertension

In patients with hypertension secondary to aldosterone secreting adrenal adenomas, medical and surgical treatments are both well described, with trans-catheter arterial embolization an uncommon form of therapy, currently. In patients where medical therapy has not provided sufficient response, and where surgical therapy is not deemed appropriate, trans-catheter arterial embolization of aldosteronomas has shown promise in a number of case series. We present the case of a 69-year-old man with hypertension refractory to medical therapy, and deemed not to be a surgical candidate for laparoscopic adrenalectomy. The patient underwent successful selective embolization of a functional adrenal adenoma, with sustained improvement in his prior hypertension, and without major complication. We conclude that trans-catheter embolization, when performed in the carefully selected suitable candidate, is a promising therapeutic option, and warrants a cohort study to assess long term outcomes.