Selective embolization of thyroid arteries for preresection or palliative treatment of large cervicomediastinal goiters.
BACKGROUND
The authors have applied the selective embolization of thyroid arteries in the treatment of voluminous cervicomediastinal goiters, especially in patients at high surgical risk or reluctant to undergo surgical intervention and radioiodine therapy.


METHODS
Selective arteriography was used to embolize the thyroid arteries in 2 patients with voluminous hyperfunctioning cervicomediastinal goiters and mediastinal compressive symptoms. The first patient had already undergone unsuccessful radioiodine metabolic therapy and had severe left ventricular insufficiency contraindicating surgery. The second patient, despite having no contraindications, declined surgery and radioiodine metabolic therapy.


RESULTS
Radiological embolization markedly reduced the goiters in volume, resolved the compressive symptoms, and also normalized thyroid hyperfunction. The second patient needed a second embolization procedure because the embolized arterial branches had partly recanalized.


CONCLUSIONS
Selective embolization of thyroid arteries can be successfully used to treat selected patients as a preoperative procedure and as an alternative to thyroid resection. Embolization can be repeated to achieve the required therapeutic aims.
Surgical Sciences Department, Sapienza University of Rome, Rome, Italy. francesco.tartaglia@uniroma1.it
Francesco
F
Tartaglia
Filippo Maria
FM
Salvatori
Giulia
G
Russo
Sara
S
Blasi
Monica
M
Sgueglia
Luciana
L
Tromba
Alberto
A
Berni
D000368:Aged; D004621:Embolization, Therapeutic; D005260:Female; D006042:Goiter / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006801:Humans; D010166:Palliative Care; D011859:Radiography; D013961:Thyroid Gland / Q000098:blood supply*