Abstract
In search of new treatment options for thyroid diseases, when conventional procedures are ineffective, contraindicated or associated with serious side effects, safety of thyroid arteries embolization in the treatment of particular thyroid diseases was evaluated. The study included eight subjects with retrosternal toxic goiter, six patients affected by Graves’ disease, five cases of retrosternal non-toxic goiter, two subjects with post-amiodarone hyperthyroidism, and one patient with severe thyroid-related orbitopathy, who underwent selective embolization of thyroid arteries. The study assessed and compared calcium–phosphate balance, modulation of thyroid autoimmunity and the presence of different side effects in patients who underwent the procedure. In addition, the serum concentrations of thyroid hormones, anti-thyroid autoantibodies and thyroid volume have been measured. Five of all enrolled subjects (22.7 %) experienced transient, not clinically relevant hypocalcaemia with no need for calcium supplementation. There were no significant changes in serum calcium levels in patients after embolization of both inferior thyroid arteries. The transient side effects associated with the treatment were neck pain and a slight increase in body temperature. Noted high concentration of free thyroid hormones immediately after the procedure was not accompanied by worsening of symptoms or signs of thyrotoxicosis. In patients with Graves’ disease, a significant decrease in thyrotropin receptor antibodies level was observed. Thyroid arterial embolization does not disturb permanently calcium–phosphate balance, modulates positively thyroid autoimmune processes and is associated with no serious post-procedure side effects. Hence, it may be considered as a safe and effective treatment modality for selected thyroid disorders.
Highlights
Thyroid gland diseases remain one of the most widespread problems in the modern clinical practice
The serum levels of anti-thyroid autoantibodies were significantly higher in subjects with Graves’ disease (GD) (6 patients) than in group not affected by this disorder (16 patients)
In subjects with GD, only the decrease in thyrotropin receptor antibodies (TRAb) level observed at the end of the follow-up was statistically significant (26 vs 6 U/ml; p = 0.043)
Summary
Thyroid gland diseases remain one of the most widespread problems in the modern clinical practice. It has been estimated that almost 9 % of women and 2 % of men are affected by a thyroid disorder [1]. Despite the existence of effective therapies for thyroid diseases, still some clinical cases require individual and alternative treatment modalities that would satisfy both patient and physician [2]. Standard therapeutic methods of hyperthyroidism include anti-thyroid drug therapy, radioiodine treatment with or without human TSH stimulation, and surgical procedures. Medical therapy may be connected with serious allergic.
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