Safety and Efficacy of Pressure-Enabled Thyroid Embolization: A Novel Approach for Symptomatic Thyroid Disease

To assess the safety and efficacy of pressure-enabled thyroid embolization (PED-TAE) for thyroid embolization.

This work aimed to evaluate the safety, feasibility, and early efficacy of PED-TAE via the inferior thyroid arteries in patients with symptomatic thyroid disease.

This retrospective cohort study took place at an academic outpatient clinic. Between May 2023 and July 2024, 22 patients underwent PED-TAE using a pressure-enabled drug delivery (PEDD) device. We retrospectively reviewed patient characteristics, procedure details, and adverse events. Patients were treated with PED-TAE predominantly via transradial access with 100 to 300 µm spheres. Ten patients (45%) underwent preplanned unilateral embolization and 12 (55%) bilateral embolization. Main outcome measures included successful embolization of the targeted thyroid lobe via an inferior thyroid artery only, as well as absence of nontarget embolization, target volume reduction, and normalization of thyroid function when appropriate.

Etiology included 11 (50%) multinodular goiters, 6 (27%) toxic nodules/goiters, 3 (14%) pre thyroidectomy, 1 (4%) Graves disease, and 1 (4%) solitary nodule. Technical and clinical success was achieved in all patients. Eighteen patients reported mild pain or discomfort, which resolved within 2 weeks. No neurovascular complications were reported. A total of 71% of patients with hyperthyroidism became euthyroid. Six-month follow-up data were available for 18 patients, in whom the mean gland volume decreased from 184.5 ± 141.4 mL pre procedure to 49.9 ± 33.7 mL (P < .05), with a mean reduction of 73%.

PED-TAE is safe and feasible, with high euthyroid conversion rates and volume reduction. A multi-institutional study is planned to validate the findings.