Endoscopic Ultrasound-Guided Ethanol Ablation for Aldosterone-Producing Adenoma (CREATE)

Inclusion Criteria:

1. Diagnosis of left-sided aldosterone-producing adrenal adenoma.
2. Unwillingness to undergo adrenalectomy or presence of contraindications to surgery.
3. Ability and willingness to provide written informed consent.

Exclusion Criteria:

1. History of alcohol allergy.
2. Inability to discontinue beta-blockers.
3. Inability to discontinue anticoagulants, antiplatelet agents, or glucocorticoids.
4. Platelet count <50 × 10^9/L or uncorrectable coagulation dysfunction.
5. Imaging findings suggestive of adrenal cyst, adrenal hematoma, or myelolipoma.
6. Presence of other active malignancies.
7. Pregnancy or breastfeeding; alcohol abuse; drug abuse; or mental disorder that may interfere with study participation.
8. Severe comorbid conditions, including any of the following: New York Heart Association (NYHA) class III-IV heart failure or hospitalization for worsening chronic heart failure within the previous 3 months; stroke or acute coronary syndrome within the previous 3 months; severe anemia (hemoglobin <60 g/L); severe hepatic disease (alanine aminotransferase ≥3 × the upper limit of normal); severe renal disease requiring dialysis or estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m²; systemic inflammatory response syndrome (SIRS); poorly controlled diabetes mellitus (fasting blood glucose ≥13.3 mmol/L); severe obesity (body mass index ≥35 kg/m²); untreated aneurysm; or any other severe medical condition that may interfere with treatment or study follow-up.
9. Poor compliance or any other condition that, in the investigator's judgment, would make the participant unsuitable for the study.