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Published in: CardioVascular and Interventional Radiology 6/2012

01-12-2012 | Clinical Investigation

Incidence and Cause of Hypertension During Adrenal Radiofrequency Ablation

Authors: Koichiro Yamakado, Haruyuki Takaki, Tomomi Yamada, Takashi Yamanaka, Junji Uraki, Masataka Kashima, Atsuhiro Nakatsuka, Kan Takeda

Published in: CardioVascular and Interventional Radiology | Issue 6/2012

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Abstract

Purpose

To evaluate the incidence and cause of hypertension prospectively during adrenal radiofrequency ablation (RFA).

Methods

For this study, approved by our institutional review board, written informed consent was obtained from all patients. Patients who received RFA for adrenal tumors (adrenal ablation) and other abdominal tumors (nonadrenal ablation) were included in this prospective study. Blood pressure was monitored during RFA. Serum adrenal hormone levels including epinephrine, norepinephrine, dopamine, and cortisol levels were measured before and during RFA. The respective incidences of procedural hypertension (systolic blood pressure >200 mmHg) of the two patient groups were compared. Factors correlating with procedural systolic blood pressure were evaluated by regression analysis.

Results

Nine patients underwent adrenal RFA and another 9 patients liver (n = 5) and renal (n = 4) RFA. Asymptomatic procedural hypertension that returned to the baseline by injecting calcium blocker was found in 7 (38.9%) of 18 patients. The incidence of procedural hypertension was significantly higher in the adrenal ablation group (66.7%, 6/9) than in the nonadrenal ablation group (11.1%, 1/9, P < 0.0498). Procedural systolic blood pressure was significantly correlated with serum epinephrine (R 2 = 0.68, P < 0.0001) and norepinephrine (R 2 = 0.72, P < 0.0001) levels during RFA. The other adrenal hormones did not show correlation with procedural systolic blood pressure.

Conclusion

Hypertension occurs frequently during adrenal RFA because of the release of catecholamine.
Literature
1.
go back to reference Livraghi T, Goldberg SN, Lazzaroni S et al (2000) Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 214:761–768PubMed Livraghi T, Goldberg SN, Lazzaroni S et al (2000) Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 214:761–768PubMed
2.
go back to reference Yamakado K, Hase S, Matsuoka T et al (2007) Radiofrequency ablation for the treatment of unresectable lung metastases in patients with colorectal cancer: a multicenter study in Japan. J Vasc Interv Radiol 18:393–398PubMedCrossRef Yamakado K, Hase S, Matsuoka T et al (2007) Radiofrequency ablation for the treatment of unresectable lung metastases in patients with colorectal cancer: a multicenter study in Japan. J Vasc Interv Radiol 18:393–398PubMedCrossRef
3.
go back to reference Gervais DA, McGovern FJ, Arellano RS et al (2003) Renal cell carcinoma: clinical experience and technical success with radio-frequency ablation of 42 tumors. Radiology 226:417–424PubMedCrossRef Gervais DA, McGovern FJ, Arellano RS et al (2003) Renal cell carcinoma: clinical experience and technical success with radio-frequency ablation of 42 tumors. Radiology 226:417–424PubMedCrossRef
4.
go back to reference Nakatsuka A, Yamakado K, Maeda M et al (2004) Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies. J Vasc Interv Radiol 15:707–712PubMedCrossRef Nakatsuka A, Yamakado K, Maeda M et al (2004) Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies. J Vasc Interv Radiol 15:707–712PubMedCrossRef
5.
go back to reference Wood BJ, Abraham J, Hvizda JL et al (2003) Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases. Cancer 97:554–560PubMedCrossRef Wood BJ, Abraham J, Hvizda JL et al (2003) Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases. Cancer 97:554–560PubMedCrossRef
6.
go back to reference Mayo-Smith WW, Dupuy DE (2004) Adrenal neoplasms: CT-guided radiofrequency ablation—preliminary results. Radiology 231:225–230PubMedCrossRef Mayo-Smith WW, Dupuy DE (2004) Adrenal neoplasms: CT-guided radiofrequency ablation—preliminary results. Radiology 231:225–230PubMedCrossRef
7.
go back to reference Yamakado K, Anai H, Takaki H et al (2009) Adrenal metastasis from hepatocellular carcinoma: radiofrequency ablation combined with adrenal arterial chemoembolization in six patients. AJR Am J Roentgenol 192:300–305CrossRef Yamakado K, Anai H, Takaki H et al (2009) Adrenal metastasis from hepatocellular carcinoma: radiofrequency ablation combined with adrenal arterial chemoembolization in six patients. AJR Am J Roentgenol 192:300–305CrossRef
8.
go back to reference Lo WK, van Sonnenberg E, Shankar S et al (2006) Percutaneous CT-guided radiofrequency ablation of symptomatic bilateral adrenal metastases in a single session. J Vasc Interv Radiol 17:175–179PubMedCrossRef Lo WK, van Sonnenberg E, Shankar S et al (2006) Percutaneous CT-guided radiofrequency ablation of symptomatic bilateral adrenal metastases in a single session. J Vasc Interv Radiol 17:175–179PubMedCrossRef
9.
go back to reference Chini EN, Brown MJ, Farrell MA et al (2004) Hypertensive crisis in a patient undergoing percutaneous radiofrequency ablation of an adrenal mass under general anesthesia. Anesth Analg 99:1867–1869PubMedCrossRef Chini EN, Brown MJ, Farrell MA et al (2004) Hypertensive crisis in a patient undergoing percutaneous radiofrequency ablation of an adrenal mass under general anesthesia. Anesth Analg 99:1867–1869PubMedCrossRef
10.
go back to reference Arima K, Yamakado K, Suzuki R et al (2007) Image-guided radiofrequency ablation for adrenocortical adenoma with Cushing syndrome: outcomes after mean follow-up of 33 months. Urology 70:407–411PubMedCrossRef Arima K, Yamakado K, Suzuki R et al (2007) Image-guided radiofrequency ablation for adrenocortical adenoma with Cushing syndrome: outcomes after mean follow-up of 33 months. Urology 70:407–411PubMedCrossRef
11.
go back to reference Al-Shaikh AA, Al-Rawas MM, Al-Asnag MA (2004) Primary hyperaldosteronism treated by radiofrequency ablation. Saudi Med J 25:1711–1714PubMed Al-Shaikh AA, Al-Rawas MM, Al-Asnag MA (2004) Primary hyperaldosteronism treated by radiofrequency ablation. Saudi Med J 25:1711–1714PubMed
12.
go back to reference Johnson SP, Bagrosky BM, Mitchell EL et al (2008) CT-guided radiofrequency ablation of an aldosterone-secreting primary adrenal tumor in a surgically unfit patient. J Vasc Interv Radiol 19:1115–1117PubMedCrossRef Johnson SP, Bagrosky BM, Mitchell EL et al (2008) CT-guided radiofrequency ablation of an aldosterone-secreting primary adrenal tumor in a surgically unfit patient. J Vasc Interv Radiol 19:1115–1117PubMedCrossRef
13.
go back to reference Mendiratta-Lala M, Brennan DD, Brook OR et al (2011) Efficacy of radiofrequency ablation in the treatment of small functional adrenal neoplasms. Radiology 258:308–316PubMedCrossRef Mendiratta-Lala M, Brennan DD, Brook OR et al (2011) Efficacy of radiofrequency ablation in the treatment of small functional adrenal neoplasms. Radiology 258:308–316PubMedCrossRef
14.
go back to reference Liu SY, Ng EK, Lee PS et al (2010) Radiofrequency ablation for benign aldosterone-producing adenoma: a scarless technique to an old disease. Ann Surg 252:1058–1064PubMedCrossRef Liu SY, Ng EK, Lee PS et al (2010) Radiofrequency ablation for benign aldosterone-producing adenoma: a scarless technique to an old disease. Ann Surg 252:1058–1064PubMedCrossRef
15.
go back to reference Onik G, Onik C, Medary I et al (2003) Life-threatening hypertensive crises in two patients undergoing hepatic radiofrequency ablation. AJR Am J Roentgenol 181:495–497PubMed Onik G, Onik C, Medary I et al (2003) Life-threatening hypertensive crises in two patients undergoing hepatic radiofrequency ablation. AJR Am J Roentgenol 181:495–497PubMed
16.
go back to reference Keeling AN, Sabharwal T, Allen MJ et al (2009) Hypertensive crisis during radiofrequency ablation of the adrenal gland. J Vasc Interv Radiol 20:990–991PubMedCrossRef Keeling AN, Sabharwal T, Allen MJ et al (2009) Hypertensive crisis during radiofrequency ablation of the adrenal gland. J Vasc Interv Radiol 20:990–991PubMedCrossRef
17.
go back to reference Yamakado K, Takaki H, Uchida K et al (2011) Adrenal radiofrequency ablation in swine: change in blood pressure and histopathologic analysis. Cardiovasc Interv Radiol 34:839–844CrossRef Yamakado K, Takaki H, Uchida K et al (2011) Adrenal radiofrequency ablation in swine: change in blood pressure and histopathologic analysis. Cardiovasc Interv Radiol 34:839–844CrossRef
18.
go back to reference Fransson BA, Keegan RD, Ragle CA et al (2009) Hemodynamic changes during laparoscopic radiofrequency ablation of normal adrenal tissue in dogs. Vet Surg 38:490–497PubMedCrossRef Fransson BA, Keegan RD, Ragle CA et al (2009) Hemodynamic changes during laparoscopic radiofrequency ablation of normal adrenal tissue in dogs. Vet Surg 38:490–497PubMedCrossRef
19.
go back to reference Vollmer RR, Balcita-Pedicino JJ, Debnam AJ et al (2000) Adrenal medullary catecholamine secretion patterns in rats evoked by reflex and direct neural stimulation. Clin Exp Hypertens 22:705–715PubMedCrossRef Vollmer RR, Balcita-Pedicino JJ, Debnam AJ et al (2000) Adrenal medullary catecholamine secretion patterns in rats evoked by reflex and direct neural stimulation. Clin Exp Hypertens 22:705–715PubMedCrossRef
20.
go back to reference Atwell TD, Wass CT, Charboneau JW et al (2006) Malignant hypertension during cryoablation of an adrenal gland tumor. J Vasc Interv Radiol 17:573–575PubMedCrossRef Atwell TD, Wass CT, Charboneau JW et al (2006) Malignant hypertension during cryoablation of an adrenal gland tumor. J Vasc Interv Radiol 17:573–575PubMedCrossRef
21.
go back to reference Sudheendra D, Wood BJ (2006) Appropriate premedication risk reduction during adrenal ablation. J Vasc Interv Radiol 17:1367–1368PubMedCrossRef Sudheendra D, Wood BJ (2006) Appropriate premedication risk reduction during adrenal ablation. J Vasc Interv Radiol 17:1367–1368PubMedCrossRef
Metadata
Title
Incidence and Cause of Hypertension During Adrenal Radiofrequency Ablation
Authors
Koichiro Yamakado
Haruyuki Takaki
Tomomi Yamada
Takashi Yamanaka
Junji Uraki
Masataka Kashima
Atsuhiro Nakatsuka
Kan Takeda
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 6/2012
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-012-0348-6

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