[Arterial thyroid embolization in thyroid diseases].
Traditional forms of treatment of the thyroid diseases: pharmacotherapy, radioiodine therapy and surgery can not always be applied. Intolerance, side effects of antithyroid drugs, low iodine uptake, high risk of surgery or disagreement with the proposed treatment was the reason for seeking alternative healing methods. With the development of interventional radiology, and gained experience in the use of arterial embolization, this method has become possible to use in treatment of thyroid diseases. The essence of this treatment is to shut down blood flow in major arteries of the thyroid by direct injection into the vessel's light of adequate size particles containing polyvinyl alcohol (PVA). The consequence of acute ischemia is septic necrosis of the glandular tissue in a field being supplied by this artery. Further repair processes and fibrosis lead to a reduction of active thyroid hormone synthesis and restriction of thyroid gland. Effects of embolization on angiogenesis, apoptosis and autoimmune reactions contribute to compensation thyroid function and significant reduction a goiter volume in course of Graves' disease. Preoperative selective embolization of a huge goiter or thyroid cancer improves surgery outcomes, reduces the risk of hemorrhage and damage to surrounding tissue. Palliative use of embolization in advanced stages of thyroid cancer reduces symptoms and improves quality of life. Little invasive nature of this procedure, the lack of serious undesirable coincidence makes embolization of thyroid arteries an attractive form of a therapy, which may become a therapeutic option in many difficult clinical situations and improve the clinical effectiveness of treatment of thyroid disease.
Wojskowy Instytut Medyczny w Warszawie, Klinika Endokrynologii i Terapii Izotopowej CSK MON. ajaroszuk@wim.mil.pl
Andrzej
A
Jaroszuk
Grzegorz
G
Kamiński
D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D013959:Thyroid Diseases / Q000473:pathology / Q000628:therapy*