Abstract No. 216 Safety and Efficacy of Thyroid Artery Embolization in Nodular Thyroid Goiter: Early Clinical Experience in an Indian Population

To assess the safety, efficacy of thyroid artery embolization and its impact on thyroid hormones level in patients with nodular goiter (MNG). This was a pilot study consisting of 20 patients. The study was performed after obtaining ethical clearance from the institutional ethical committee. The patients included in this study were either having solitary thyroid nodule (STN) measuring > 20 cc or MNG with thyroid size > 5 cm or STN/MNG with cosmetic or compressive symptoms irrespective of size. The thyroid lesions who were Bethesda grade IV/V were excluded from the study. Out of 20 patients, 17 patients were having STN and were euthyroid at baseline. 3 of 20 patients had diffuse MNG and were hyperthyroid at baseline. All patients were either Bethesda grade II (17/20) or Bethesda grade III (3/20) on FNAC. In all patients, hormonal T3, T4, TSH) and radiological evaluations (USG/MRI) were done at baseline, 24 hours, 1week, 1 month and 6-month post procedure. In all 20 patients, 100% technical success of selective cannulation of both superior thyroid artery and inferior thyroid artery and thyroid IMA artery (2/20) was achieved. 45 of the 82 thyroid arteries were successfully embolized with PVA particles (300-500um). Minor expected complications like transient neck pain, fever and nausea occurred in 17 patients (85%) post embolization for 2-3 days. Subclinical transient thyroiditis was seen in 3 patients of MNG at 1 week which resolved at 1 month. At 6 month follow up on MRI, there was ∼ 50% reduction (from mean volume of 41.8 cc to 22.3 cc) in volume of dominant nodules which was statistically significant (p< 0.001). No major complication or mortality was seen up to 6 month follow up. All 20 patients including 3 hyperthyroid patients were euthyroid at 6 months follow up. Thyroid artery embolization is a safe and efficacious procedure for treatment of MNG with no major complications seen up to 6-month follow up.