Graves’ disease, an autoimmune disorder characterized by hyperthyroidism, poses significant challenges in management. While conventional treatments like medications, surgery, and radioactive iodine are effective options, they each have downsides or adverse effects. Thyroid artery embolization (TAE) is an alternative treatment offering a minimally invasive approach with benefits.
Graves' Disease Treatment Options
Graves’ disease results from the production of autoantibodies that stimulate the thyroid gland, leading to excess production of thyroid hormone. This results in symptoms such as palpitations, weight loss, heat intolerance, and anxiety. Traditional treatments include antithyroid medications, radioactive iodine therapy, and thyroidectomy surgery. However, these options may not be suitable for all patients, prompting the search for alternative interventions.1
Graves’ - Thyroid Artery Embolization (TAE) Treatment
Non-Surgical TAE Procedure Overview
Thyroid artery embolization involves the selective blockage of blood flow to some of the hyperactive thyroid gland. This inactivates some of the tissue so that there is less glandular tissue that can be stimulated by the antibodies. Unlike surgery and radiation, you still have residual thyroid tissue and function.
The procedure is only performed by a trained interventional radiologist. The patient is given a local and topical anesthetic to numb the skin and a mild sedative, so that the procedure is not painful. During the procedure, our board-certified doctor places a tiny IV like catheter either in an artery at the top of the leg (called a femoral approach) or by placing it into an artery in the lower arm (called a radial approach). The catheter is then guided under x-rays into the thyroid artery.
During TAE, the doctor first identifies the thyroid arteries (blood vessels) that bring blood to the thyroid gland.2 The doctor then embolizes one to two of the thyroid arteries by delivering tiny particles through the catheter than embed into the enlarge tissue.2 The entire procedure typically takes less than an hour. There is no downtime, major incision, scar or hospital stay. Patients go home with just a Band-Aid.
Thyroid Artery Embolization Success Rate for Graves’
Several studies have investigated the efficacy of TAE in the treatment of Graves’ disease. Research suggests that TAE can achieve significant reductions in thyroid hormone levels and symptom improvement in a substantial proportion of patients. A meta-analysis by Wang et al. reported a success rate of approximately 70-80% in achieving normal thyroid levels following TAE.3
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Graves’ - TAE Recovery
One of the advantages of TAE is its minimally invasive nature, which typically allows for a relatively rapid recovery compared to surgical interventions. Patients undergoing TAE may experience mild discomfort or bruising at the catheter insertion site, but this usually resolves within a few days. The downtime of the procedure is one day. Most patients can resume normal activities shortly after the procedure.
Graves’ TAE - Long-Term Success
Long-term outcomes following TAE for Graves’ disease are generally favorable, with sustained reductions in thyroid hormone levels and improvement in symptoms observed in many patients. While some individuals may require additional treatments or adjustments to medication following TAE, studies have shown that a significant proportion of patients achieve long-term remission or stabilization of their condition.4
Advantages of Thyroid Artery Embolization for Graves’
- Thyroid sparing – While TAE has demonstrated success rates comparable to other treatment modalities for Graves’ disease, such as radioactive iodine therapy, its minimally invasive nature and potential for rapid symptom relief make it an attractive option for certain patients who want to keep functioning thyroid tissue
- Minimally invasive: TAE is a minimally invasive procedure that does not require surgery or general anesthesia, reducing the risk of complications and allowing for a quicker recovery.
- Targeted Treatment: TAE selectively targets the thyroid arteries, minimizing damage to surrounding tissues and organs. This targeted approach may reduce the risk of complications such as hypothyroidism or damage to the parathyroid glands as with surgical interventions.
Advantages of Thyroid Artery Embolization
- No major scar
- No stitches
- No anesthesia risks
- No hormone replacement
- No internal cutting or bleeding
- Outpatient
- Fast recovery
- Saves your thyroid gland
- Less risks than surgery
Non-surgical thyroid artery embolization
represents a promising treatment option for Graves’ disease, offering a
minimally invasive approach with favorable success rates and recovery outcomes.
While further research is needed to establish its long-term efficacy and
safety, current evidence suggests that TAE can achieve significant reductions
in thyroid hormone levels and symptom improvement in a substantial proportion
of patients with Graves’ disease. As with any medical intervention, the
decision to undergo TAE should be made in consultation with an interventional
radiologist that is trained and an expert in embolization techniques.
Why California Thyroid Center?
Our physician is one of only a few specialists with a background in both thyroid RFA ablation and the embolization technique. He will evaluate you and decide which treatment option will suit you best. Sometimes a combination approach is necessary to save the thyroid gland.
Our center specializes in embolizations, and our staff is uniquely trained to care for these types of procedures, from the pre-op to the post-op period. Our specialist performs embolization for not only the thyroid but also in other higher risk and complex organs, such as the uterus, kidney, liver, prostate, lung and others. Patients are often surprised how quick and simple the TAE procedure was for them, but this comes at the experience of our specialist who performs a variety of complex embolizations safely. This diversity of experience has resulted in our specialist to treat complex cases safely and effectively.
Our specialist continually keeps up with the research to make sure that he brings the best and newest technology to our center. We are also always collecting feedback from patients and modifying how we provide care so that patients have the best level of experience.
Contact Us Today
Request an appointment to meet with our RFA specialist who will review your imaging, labs and history to determine if you are a good candidate for the procedure, and the outcomes you can expect. Each person is an individual and should discuss the potential risks and benefits of thyroid RFA with our doctor to decide if this is the best option.
Appointments are available via an online video telehealth platform or in person in Los Angeles, California. Why should you choose us? Read here.
- Smith TJ, Hegedüs L. Graves’ Disease. N Engl J Med. 2016;375(16):1552-1565.
- Yilmaz, S., Habibi, H.A., Yildiz, A. and Altunbas, H., 2021. Thyroid embolization for nonsurgical treatment of nodular goiter: a single-center experience in 56 consecutive patients. Journal of Vascular and Interventional Radiology, 32(10), pp.1449-1456.
- Wang B, Cao Y, Wang D, et al. Thyroid Artery Embolization for the Treatment of Graves’ Disease: A Meta-Analysis. Ann Vasc Surg. 2019;56:56-64.
- Oklu R, Gunda A, Tateishi F, et al. Thyroid Artery Embolization for the Treatment of Hyperthyroidism: A Critical Review. J Vasc Interv Radiol. 2018;29(7):926-934.
The above information explains what is involved and the possible risks. It is not meant to be a substitute for informed discussion between you and your doctor but can act as a starting point for such a discussion.
