Abstract / Summary
Management of large symptomatic thyroid nodules remains challenging. Although ultrasound-guided thermal ablation is an established minimally invasive treatment, multiple treatment sessions may be required for large nodules. Thyroid artery embolization (TAE) has emerged as a potential alternative treatment; however, clinical evidence remains limited. This study evaluated the efficacy and safety of TAE performed via the transradial approach for large symptomatic thyroid nodules. This retrospective study included 21 consecutive patients with benign thyroid nodules larger than 40 mL who underwent transradial TAE and completed 6-month follow-up. Nodule volume, volume reduction rate (VRR), symptom score, cosmetic grade, thyroid function, and complications were evaluated at baseline, 1 month, and 6 months. Changes over time were analyzed using the Friedman test with post hoc Wilcoxon signed-rank tests, and changes in thyroid function status were analyzed using Cochran’s Q test. Median nodule volume decreased from 72.7 mL at baseline to 33.7 mL at 1 month and 11.0 mL at 6 months, corresponding to a median VRR of 53.7% and 85.3%, respectively (both p < 0.001). Symptom score and cosmetic grade improved significantly during follow-up (both p < 0.001). Five patients (23.8%) had substernal extension, all of whom demonstrated marked reduction of the substernal component, with improvement in extension grade observed in four patients. No major complications, permanent neurological deficits, or radial artery occlusion occurred. Minor adverse events were transient, and transient biochemical thyroid function abnormalities were not associated with clinical symptoms or the need for antithyroid medication or thyroid hormone replacement therapy. Transradial TAE appears to be a feasible minimally invasive treatment option for selected patients with large symptomatic thyroid nodules. In this cohort, TAE was associated with substantial volume reduction and significant improvement in symptoms and cosmetic outcomes, with no major complications observed. These preliminary findings suggest that TAE may have a potential role in selected patients with large nodules or substernal extension, particularly when percutaneous thermal ablation is technically challenging.