Evaluation of selective embolization of thyroid arteries (SETA) as a preresective treatment in selected cases of toxic goitre
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* Corresponding author: Andrzej Lewiński alewin@csk.umed.lodz.pl
1 Department of General, Oncological and Endocrine Surgery, Medical University of Lodz, Polish Mother's Memorial Hospital – Research Institute, Lodz, Poland
2 Department of Endocrinological, General and Vascular Surgery, Copernicus Memorial Hospital, Lodz, Poland
3 Department of Radiology, Copernicus Memorial Hospital, Lodz, Poland
4 Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Polish Mother's Memorial Hospital – Research Institute, Lodz, Poland
Thyroid Research 2009, 2:7 doi:10.1186/1756-6614-2-7
Published: 31 July 2009Abstract
Background
in recent years, an increasing interest in the application of selective embolization of thyroid arteries (SETA) in the treatment of thyroid diseases is observed. In the present report, we analyse the value, safety and possible indications for preresective SETA in cases of large toxic goitres.
Patients and method
the study group comprised 10 patients with large toxic goitre (thyroid volume 254 ± 50 mL), including one patient with cervicomediastinal goitre and one patient with anti-thyroid drug intolerance in state of overt thyrotoxicosis. All the patients underwent SETA of the superior and/or inferior thyroid arteries, followed by thyroidectomy, performed up to thirty-six hours after SETA (23.1 ± 11 h). After embolization, selective angiographies of thyroid arteries were performed to ensure that the targeted arteries had been completely occluded.
Results and conclusion
in all the patients, SETA decreased blood flow through the thyroid. Preresective SETA reduced blood loss during and after thyroidectomy and decreased the operating time, but the differences were too small to justify routine applications of preresective SETA as an adjunct to surgical treatment of toxic goitre. On the other hand, SETA is a safe and minimally-invasive technique, which may become an attractive option for quick preparation to surgery in selected patients with toxic goitre, who present anti-thyroid drug intolerance or refuse radioactive iodine treatment.