Thyroid artery embolization

Non-surgical treatment of substernal or intrathoracic goitre (Thyroid artery embolization)

What is a substernal goiter, and what are its symptoms?

A substernal goiter is a type of multinodular goiter that extends below the thoracic inlet and into the chest cavity. Symptoms can include difficulty swallowing, shortness of breath, hoarseness, chest pain, and a visible bulge in the neck or chest.

How is a substernal goiter diagnosed?

Diagnosis typically involves imaging tests such as a CT scan, MRI, or ultrasound. Your doctor may also order blood tests to check your thyroid function.

What are the treatment options for a substernal goiter?

Treatment depends on the size and location of the goiter, as well as any symptoms you may be experiencing. Surgery ,radioactive iodine therapy and thyroid artery embolization are options for treatment.

What are the risks associated with surgery for substernal or intrathoracic goiter?

Surgical removal of substernal or intrathoracic goiter can be a complex procedure and carries risks such as bleeding, infection, damage to surrounding structures, and vocal cord paralysis. However, the overall complication rate for this procedure is relatively low, and the benefits of surgery in relieving symptoms and preventing potential complications outweigh the risks.

Can a substernal goiter become cancerous?

While most substernal goiters are benign, there is a slightly higher risk of cancer compared to goiters located solely in the neck. Your doctor may recommend a biopsy to determine if the goiter is cancerous, and if so, additional treatment may be necessary.

What is thyroid artery embolization, and how does it work?

Thyroid artery embolization is a minimally invasive procedure that involves injecting a substance into the blood vessels that supply the thyroid gland, causing the blood vessels to narrow or block. This reduces blood flow to the goiter, causing it to shrink in size over time.

What are the benefits of thyroid artery embolization?

Thyroid artery embolization offers several benefits over surgery, including a lower risk of complications, a shorter hospital stay, and a quicker recovery time. It is also a good option for patients who are not candidates for surgery due to age or underlying medical conditions.

Who is a good candidate for thyroid artery embolization?

Patients with large, symptomatic substernal or intrathoracic goiters that are not responding to medication may be good candidates for thyroid artery embolization. However, it's important to discuss all of your treatment options with your doctor and determine the best course of action based on your individual needs and preferences.

What are the risks associated with thyroid artery embolization?

As with any medical procedure, there are risks involved with thyroid artery embolization, including bleeding, infection, stroke and nerve damage. However, the risks are typically low, and most patients recover without any significant complications.

How long does it take for the goiter to shrink after thyroid artery embolization?

The size of the goiter typically begins to decrease within a few weeks to months after the procedure, with maximum shrinkage occurring around six months to a year after the procedure.

Can a goiter recur after thyroid artery embolization?

While thyroid artery embolization can be effective at reducing the size of a goiter, there is a small risk of the goiter recurring over time. However, with proper monitoring and follow-up care, most patients are able to manage their symptoms effectively and avoid a recurrence.

What to expect after thyroid artery embolization?

After thyroid artery embolization, patients can expect to experience some mild to moderate discomfort in the neck area for a few days, which can be managed with over-the-counter pain medications. It is also common to experience a sore throat, hoarseness, and difficulty swallowing for a short period after the procedure.

In addition, patients may notice a decrease in the size of the thyroid nodules and an improvement in symptoms such as difficulty breathing or swallowing within a few weeks to months after the procedure. It's important to note that the size reduction of the nodules may not be immediate and may take several months to achieve maximum results.

Transient elevation of throid hormones could be observed during 3 weeks and anti-thyroid drugs could be given to patients.

Follow-up care after the procedure is essential to monitor the patient's condition and ensure that the nodules are responding appropriately to the treatment. Your doctor may recommend regular ultrasounds and blood tests to assess the size and function of the thyroid gland.

Overall, the recovery period after thyroid artery embolization is generally short, with most patients able to return to their normal activities within a few days. However, it is important to follow your doctor's instructions for post-procedure care and to report any persistent or worsening symptoms to your healthcare provider.

Is thyroid artery embolization safe and effective?

TAE is a safe and effective treatment option for patients with symptomatic benign thyroid nodules and can also be considered as an alternative to surgery for patients with substernal or intrathoracic goiters. However, it is important to discuss the potential benefits and risks of the procedure with your healthcare provider to determine if TAE is the right treatment option for you.