Thyroid Artery Embolization : Procedure, Indications And Aftercare

Introduction

The thyroid is a butterfly-shaped gland located in front of your neck and is a part of the human endocrine system (a network of glands producing hormones that control various functions in the body). The thyroid gland secretes hormones that are essentially required for your body’s normal metabolism, growth, and development.  In some cases, your thyroid gland may malfunction and become underactive (hypothyroid) or overactive (hyperthyroid). Thyroid diseases are quite common and are more likely in females. 
In this blog, we will talk about a procedure called “Thyroid Artery Embolization” which is used to treat an overactive thyroid. It is considered when other treatments, such as medication or radioactive iodine therapy, are not suitable or have not been effective. Here let’s take a detailed look at the procedure. 

What Is Thyroid Artery Embolization?

Definition and Purpose
Thyroid Artery Embolization is a medical technique used to treat conditions that result from excessive production of thyroid hormones such as thyroid nodules and hyperthyroidism. In this procedure, one or more of the arteries that provide blood to the thyroid gland are intentionally blocked (embolized) aiming to reduce the blood supply to the gland. This helps limit the hormone production and thus subside the symptoms resulting from a hyperactive thyroid such as rapid heart rate, weight loss, anxiety, and heat intolerance. It is a less invasive method to manage hyperthyroidism without the need for surgery. It helps preserve the function of the gland while reducing its activity.
What are the Alternative Treatment Options?
Although Thyroid Artery Embolization is a novel approach to treat many problems and thyroid-related issues, depending upon the individual’s circumstances and doctor’s recommendation there are a few similar options available such as:
Medications: Your doctor will prescribe you some anti-thyroid medicines, these medicines will slow down the activity of an overactive thyroid (hyperthyroidism).
Radioactive Iodine Therapy: The therapy uses radioactive iodine to kill the overactive cells of the thyroid and helps in reducing the size of the enlarged thyroid gland.
Thyroidectomy: Thyroidectomy is a surgical procedure that is done to remove all parts of the thyroid gland. Thyroidectomy is often considered by doctors as a solution to treat thyroid nodules or thyroid cancer.  

How Does a Thyroid Artery Embolization Work?

Here’s what to expect before and during the procedure:

Before The Procedure 

• Thyroid Artery Embolization is an outpatient procedure, where you can return home on the same day. However, in some cases, you might need hospitalization depending upon your specific case. 
• Your doctor will review your medical history and will guide you through the procedure, its risks, and benefits.
• You may be prescribed certain imaging tests such as an MRI, CT Scan, or Ultrasound before the procedure 
• You may be asked to fast for a set amount of time before the surgery.
• Your doctor might ask you to avoid smoking and consumption of alcohol a few days prior to the surgery as these can interfere with your recovery.

The Day of the Procedure

• You will be taken to the operation theater and will be given a surgical gown to wear. 
• You will be asked to lie down on the operating table.
• Your doctor will give you local anesthesia to reduce the pain and discomfort during the procedure.
• Your surgeon will make one small incision in your wrist or groin area.
• For the real-time view of the procedure, the surgeon may use fluoroscopy or ultrasound guidance.
• Your doctor will insert a catheter through the incision to reach the thyroid arteries supplying the gland.
• Once the catheter is in position, the interventional radiologist injects tiny particles or embolic agents through the catheter and into the thyroid arteries. These particles block the blood vessels that supply blood to the thyroid gland.
• Contrast dye and imaging techniques are used by the interventional radiologist to verify that the thyroid gland's blood supply has been adequately cut off or obstructed (embolised).
• Your doctor will carefully withdraw the catheter following a successful embolization, and the incision site will be closed using sutures. 
• Your doctor will cover the incision site with a surgical bandage to cover the incision site. 

Thyroid artery embolization is considered a minimally invasive and relatively safe procedure. You may discuss any doubts or queries with your surgeon well in advance, to have a safe procedure and recovery.

Recovery and Aftercare

After the completion of the procedure, the patients will require a proper follow-up and post-care routine to ensure a smooth recovery. Following are the steps to be followed in the aftercare phase.

• After the procedure, you will be kept under observation for a few hours to a few days (depending upon the individual’s condition) to monitor your recovery and any other potential complications.
• Your doctor will briefly guide you through the steps to be followed after the procedure. You will be asked to avoid any kind of strenuous activities for a few days. 
• Your doctor will prescribe pain medications to manage any discomfort. 
• It is strongly recommended to attend follow-up appointments with your doctor as these will help you evaluate your recovery. 
• On the basis of your recovery rate your doctor will plan any further treatment if required.

Benefits and Advantages of Thyroid Artery Embolization

Thyroid Artery Embolization provides a number of advantages and benefits. The following are some of the unique benefits and advantages of thyroid artery embolization:

• Minimally Invasive Procedure: Thyroid Artery Embolization is a minimally invasive technique, that leads to less discomfort and a quicker recovery.
• Thyroid functioning: Thyroid artery embolization typically preserves some level of thyroid function. This allows individuals to maintain some thyroid hormone production, which is important for overall health.
• No scars: The technique is less invasive than typical thyroid surgeries, thus it leaves fewer scars or no scars as the procedure involves smaller incisions.
• Reduced symptoms: By decreasing the blood flow to an overactive thyroid gland, thyroid artery embolization can effectively cure hyperthyroidism. This may help in managing symptoms like tremors, anxiety, weight loss, and rapid heartbeat.
• Quick recovery: Thyroid Artery Embolization is a same-day procedure, allowing patients to leave the hospital quickly or go home the same day (depending upon the individual recovery rate and condition). You can return to your regular activities in a few days or a week.

Risks and Potential Complications of Thyroid Artery Embolization

Thyroid Artery Embolization is typically regarded as a safe and effective surgery. Here are some of the potential risks associated with the procedure:

• Pain and discomfort during the procedure: After the procedure, some patients may experience pain or discomfort at the site where the catheter was inserted or in the thyroid area. This discomfort is usually mild and can be managed with pain medications.
• Infection: There is a chance of infection at the catheter insertion site, however, it is uncommon. To reduce this risk, precautions are taken during and after the surgery, such as following proper sterile techniques.
• Thyroid Function Changes: While the goal of thyroid artery embolization is to reduce thyroid hormone production, there is a possibility of unintentionally affecting thyroid function more than intended, leading to hypothyroidism (underactive thyroid).
• Ineffectiveness: Thyroid artery embolization may not effectively control hyperthyroidism in all cases, and the procedure's success can vary among individuals.
• Allergic Reaction: Some individuals may have an allergic reaction to the contrast dye or medications used during the procedure. Allergic reactions are typically mild and can be treated promptly.

Conclusion

The goal of thyroid artery embolization is to shrink the thyroid gland or reduce its activity, alleviating symptoms and improving the patient's quality of life. The procedure has shown promising results in managing thyroid disorders, especially in cases where conventional treatments like medication or surgery may not be suitable. Thyroid artery embolization is generally considered safe, with a low risk of complications, and it can often be performed on an outpatient basis. 

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