Triple T: Faster, Simpler Therapy for Common Cause of High Blood Pressure, Study Finds - Video

Doctors at Queen Mary University of London, Barts Health NHS Trust, and University College London have led the development of a simple, minimally invasive Targeted Thermal Therapy (Triple T) that has the potential to transform medical management of a common, but commonly overlooked, cause of high blood pressure. Findings are published in the lancet.

High blood pressure affects one in three adults, of whom a hormonal condition called primary

aldosteronism accounts for one in twenty cases. However, fewer than one percent of those affected are ever diagnosed.

Triple T offers a faster, safer alternative to surgery, by selectively destroying the small adrenal nodule without removing the gland. The new treatment harnesses the energy of waves, adapting two well-established medical techniques: radiofrequency or microwaves generate heat in a small needle placed into the malfunctioning tissue, causing a controlled burn; ultrasound uses reflected sound waves to create a real-time video of the procedure.

In Triple T, as in routine endoscopy, a tiny internal camera -- in this case using ultrasound as well as light -- is passed by mouth into the stomach. The endoscopist visualises the adrenal gland and guides a fine needle from the stomach precisely into the nodule. Short bursts of heat destroy the nodule but leave the surrounding healthy tissues unharmed. This minimally invasive approach takes only 20 minutes and eliminates the need for internal or external incisions.

The study is called FABULAS, the name being an acronym for Feasibility study of radiofrequency endoscopic ABlation, with ULtrasound guidance, as a non-surgical, Adrenal Sparing treatment for aldosterone-producing adenomas.

FABULAS tested Triple T in 28 patients with primary aldosteronism, whose molecular scan had pinpointed a hormone-producing nodule in the left adrenal gland. The new procedure was found to be safe and effective, with most patients having normal hormone levels six months later. Many participants were able to stop all blood pressure medications, with no recurrence of the condition.

Reference: Endoscopic, ultrasound-guided, radiofrequency ablation of aldosterone-producing adenomas (FABULAS): a UK, multicentre, prospective, proof-of-concept trial, Argentesi, GiuliaBastos, Jose et al., The Lancet, Volume 0, Issue 0