A Paradigm Shift in Treatment for Goiters 

Goiters, characterized by an enlargement of the thyroid gland, can cause various symptoms and impact the quality of life for affected individuals. While surgery has traditionally been the primary treatment option for goiters, an innovative procedure called thyroid artery embolization (TAE) has emerged as a minimally invasive alternative.

In this blog, we will explore the benefits of thyroid artery embolization for goiters and shed light on its potential to revolutionize the management of this common thyroid condition.

Goiters are commonly caused by an imbalance in thyroid hormone production or by the growth of benign nodules within the thyroid gland. They can manifest as a visibly enlarged thyroid gland in the neck, resulting in cosmetic dissatisfaction or symptoms such as difficulty swallowing, breathing problems, hoarseness, and discomfort. Historically, the goiter treatment approach has often involved surgical removal of the thyroid gland, a procedure known as thyroidectomy.

Thyroid artery embolization is a relatively new technique that has gained recognition as a minimally invasive alternative to surgery for goiter treatment. In this procedure, interventional radiologists use imaging guidance and perform an angiogram in order to navigate small catheters through the blood vessels and precisely deliver embolic agents to the arteries supplying the thyroid gland. By blocking the blood flow to the gland, TAE reduces the size of the goiter and alleviates associated symptoms.

Benefits of Thyroid Artery Embolization

• Minimally Invasive: Compared to traditional surgery, TAE is a minimally invasive procedure that avoids the need for a large neck incision and the associated risks of general anesthesia. It is performed using local anesthesia and conscious sedation, resulting in a shorter recovery time and reduced post-operative discomfort.
• Preserves Thyroid Function: One of the significant advantages of TAE is that it provides a very high likelihood of preserving thyroid function. While surgery often involves the complete or partial removal of the thyroid gland, TAE targets the blood supply to the gland without directly interfering with its structure. Because nodules typically have more blood flow than the surrounding gland, much of the nodular portion of the gland is treated, with relative sparing of normal thyroid.  This allows the thyroid to continue producing hormones, preventing the need for lifelong hormone replacement therapy.
• High Success Rates: Although data is limited, most recently thyroid artery embolization has demonstrated high success rates in reducing the size of goiters. Studies have reported significant volume reduction and symptomatic relief in the majority of patients treated with TAE. The procedure is particularly effective for patients with large or multiple nodules and can provide relief for those who may not be ideal candidates for surgery.
• Minimal Complications: TAE has a low complication rate compared to surgical interventions. Since it is a minimally invasive procedure, the risk of surgical site infection, bleeding, and damage to nearby structures (such as the nerve controlling the voice box) is significantly reduced. Most patients experience only mild post-procedural discomfort, which can be managed with over-the-counter pain medications.
• Outpatient Procedure: In most cases, thyroid artery embolization can be performed on an outpatient basis. This means that patients can undergo the procedure and return home on the same day, without the need for an overnight hospital stay. This convenience further contributes to the overall positive patient experience and reduces healthcare costs.

Thyroid artery embolization represents a significant advancement in the treatment of goiters. With its minimally invasive nature, preservation of thyroid function, high success rates, and minimal complications, TAE offers a promising alternative to traditional surgery.

While there are a lot of positive things to be said about thyroid artery embolization—there are a few things to keep in mind.  Unlike surgery, embolization requires time to be effective.  This timeline is typically 3-6 months.  Additionally, embolization can result in significant leakage of thyroid hormone into the blood stream.  This varies greatly from person to person and consequently may require frequent monitoring of labs, uncommonly taking medication to counteract the thyroid hormone, and even more rarely hospital admission.  In rare circumstances, you may have to be admitted for management of a complication known as “thyroid storm”.

As the medical community continues to explore and refine this innovative technique, it has the potential to revolutionize the management of goiters, providing patients with an effective and safe treatment option that improves their quality of life.

Read about thyroid artery embolization at Fairfax Vascular Center, and schedule a consultation to learn more.