Thyroid Arterial Embolization Therapy for Graves' Disease: a median follow-up of 11.5 years

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 432-458-Thyroid Autoimmunity
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-440
Yuanyuan Liu* and Haipeng Xiao
First Affiliated Hospital, Sun Yat-sen University, China
Purpose: Thyroid arterial embolization therapy for Graves’ disease was described years ago but its use has not been rigorously evaluated. Here the long-term outcomes and safety of this procedure was evaluated.

Materials and Methods: The review board approved this study. 34 patients with Graves’ disease treated with thyroid arterial embolization during 1997 and 2009 were followed for a median of 11.5 years. Symptoms and signs of hyperthyroidism, levels of thyroid hormones and thyroid-stimulating hormone (TSH), size and blood flow of the thyroid, immunological status, and complications were monitored. 

Results:  34 patients were followed for a median of 11.5 years. 17 of 34 patients (50%) achieved euthyroid status within 2 months after the procedure, among which 4 had a recurrence (23.5%) at 11, 42, 50 and 106 months after embolization. The remaining 17 (50%) patients had partial response to the procedure and required additional treatments to maintain a euthyroid state. Patients embolized with smaller granules of polyvinyl alcohol (PVA) had a higher cure rate (P<0.05). Those who had 3 arteries embolized had a trend of achieving better response. Patients with a shorter duration of hyperthyroidism before embolization had a higher cure rate (P<0.05). Patients with higher levels of thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) before embolization had a lower risk of recurrence (P=0.008 and P=0.001, respectively). No  serious complications or exacerbation of Graves’ ophthalmopathy occurred after the procedure.When the levels of TRAb and CD19+CD5- lymphocytes were correlated with the thyroid function, there was a significant difference between euthyroid and hyperthyroid patients.

Conclusion:  Thyroid arterial embolization is a minimally invasive and safe alternative approach for the treatment of Graves’ disease with good long-term outcomes.

Nothing to Disclose: YL, HX

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