Adrenal Artery Embolization: Anatomy, Indications, and Technical Considerations

Abstract

Adrenal artery embolization can be used for management of adrenal tumors (palliative for pain relief, debulking, or hormone suppression) and treatment of acute bleeding from ruptured adrenal tumors, traumatic adrenal injury, and aneurysms. Variant arterial supplies, options for embolic agents, and potential complications are important considerations.

Endovascular Treatment of a Post-Traumatic Adrenal Hemorrhage in a Pediatric Patient: A Case Report

“…Embolization can be performed with various agents, including coil, glue, and gelatin sponge. Embolic agents must be applied on a case by case basis, considering the clinical purpose, preference of the radiologists, and accessibility of the agent (9). In our case, we preferred N-butyl cyanoacrylate glue for primary superior and middle adrenal arterial embolization because the vessels are of small-caliber and relatively tortuous.…”

“…The following three possible mechanisms for the occurrence of adrenal hemorrhage have been proposed: 1) Compression of the adrenal gland against the spinal column; 2) An acute increase in the intra-adrenal venous pressure due to compression of the infe-rior vena cava. This may explain why the right adrenal gland is more commonly affected; and 3) Shearing of small vessels that perforate the adrenal capsule, resulting from secondary deceleration forces (9).…”

A Case of Cushing Syndrome Successfully Treated with Superselective Adrenal Arterial Embolization of an Adrenocortical Adenoma with a 6-Month Follow-Up

“…Because of the complex vascular supply to the adrenal gland by those three arteries, embolization of a single artery will unlikely result in infarction of the entire gland (3). Adrenal artery embolization is a reasonably safe and minimally invasive procedure that has been used selectively for the management of variable adrenal diseases, including malignancies, hemorrhage, and adrenal artery aneurysms (3,(6)(7)(8). It has also been used for benign neoplasms such as aldosterone-secreting adrenocortical adenomas and pheochromocytoma (3,6,7).…”

“…Adrenal artery embolization is a reasonably safe and minimally invasive procedure that has been used selectively for the management of variable adrenal diseases, including malignancies, hemorrhage, and adrenal artery aneurysms (3,(6)(7)(8). It has also been used for benign neoplasms such as aldosterone-secreting adrenocortical adenomas and pheochromocytoma (3,6,7). Adrenal artery embolization has been reported in only two cases of Cushing syndrome due to adrenocortical adenoma (6)(7)(8).…”

The Long-term Effect of Adrenal Arterial Embolization for Unilateral Primary Aldosteronism on Cardiorenovascular Protection, Blood Pressure, and the Endocrinological Profile

“…Transcatheter adrenal arterial embolization (TAAE) using ethanol as a nonsurgical therapy for APA had been performed. TAAE for endocrinologically active adrenal tumors is a minimally invasive procedure that can be used to suppress excess adrenal hormone production (14). In some previous reports, TAAE had been used for PA patients refusing surgery or at high risk of surgical complications.…”