Koichiro Yamakado MD, PhD, Presenter: Nothing to Disclose

Atsuhiro Nakatsuka MD, Abstract Co-Author: Nothing to Disclose

Haruyuki Takaki MD, Abstract Co-Author: Nothing to Disclose

Takashi Yamanaka MD, Abstract Co-Author: Nothing to Disclose

Junji Uraki MD, Abstract Co-Author: Nothing to Disclose

Masataka Kashima MD, Abstract Co-Author: Nothing to Disclose

Kan Takeda MD, Abstract Co-Author: Nothing to Disclose

To prospectively evaluate the incidence and the causes of hypertension during adrenal adrenal radiofrequency (RF) ablation.

This prospective study was approved by our institutional review board and a written informed consent was obtained from all 18 patients. Blood pressure was monitored during adrenal RF ablation in 9 patients with adrenal tumors [metastases (n=6), hyperfunctioning adenomas (n=2), adrenal cancer (n=1)] and during liver and renal RF ablation in other 9 patients with liver and renal tumors [hepatocellular carcinoma (n=4), liver metastasis (n=1), renal cell carcinoma (n=4)]. Adrenal hormones were also measured before and during RF ablation. Incidence of hypertension (systolic blood pressure > 200 mmHg) was compared between the patient group with adrenal RF ablation and that with liver and renal RF ablation. Factors causing hypertension was evaluated by Fisher’s exact test for categorical variables (sex and target organ) and t-test for continuous variables (age, tumor size, blood pressure, adrenal hormone levels before RF ablation, and differences in adrenal hormone levels between during and before RF ablation).

The incidence of hypertension was significantly higher in the adrenal RF ablation group (66.7%, 6/9) than in the liver and renal RF ablation group (11.1%, 1/9) (p<.05). Both the adrenaline (4480.0 +/- 2926.4 pg/ml vs. 102.0 +/- 148.7 pg/ml0, p<.0001) and the noradrenaline (942.7 +/- 422.1 pg/ml vs. 94.8 +/-291.1 pg/ml, p<.0001) levels significantly increased in patients who experienced hypertension than those who did not.

Hypertension occurs frequently during adrenal RF ablation due to a release of adrenomedullary hormones.

Hypertension frequently occurs during adrenal radiofrequency ablation due to a release of adrenomedullary hormones. We have to keep mind it and make a preparation to deal with hypertension. 

Yamakado, K, Nakatsuka, A, Takaki, H, Yamanaka, T, Uraki, J, Kashima, M, Takeda, K, Adrenal Radiofrequency Ablation: Incidence and Cause of Hypertension.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003853.html