Shrink your goiter — and keep your thyroid.
Surgery removes the gland and often means hormone pills for life. TAE takes a different path: an under-1-hour, outpatient procedure that blocks the arteries feeding the goiter — no incision, no scar, no hospital, home with a Band-Aid. Performed by Dr. Atabak Allaei, one of very few physicians experienced in both thyroid embolization and RFA.
Goiter embolization at a glance
Patient satisfaction at 6 months4
Volume reduction by 3 months10
Thyroid artery embolization (TAE) is a non-surgical, outpatient treatment that shrinks a thyroid goiter by blocking its blood supply. Through a tiny catheter guided by X-ray, Dr. Allaei places tiny particles into one to three arteries feeding the goiter — done in under an hour,5 with no incision, scar, or hospital stay. Unlike surgery, TAE preserves the thyroid gland, avoiding permanent hypothyroidism and lifelong hormone replacement. Volume drops up to 32% by three months, and over 98% of patients at six months were satisfied and would recommend it.4
What is a thyroid goiter?
A goiter is an enlargement of the thyroid gland1 — affecting men and women, with women at higher risk, especially during pregnancy.2,3
Thyroid artery embolization (TAE) is a non-surgical outpatient alternative treatment option to prevent total surgical removal and loss of the thyroid gland. A goiter refers to the enlargement of the thyroid gland.1 This condition can affect both men and women. However, women carry a higher risk of developing goiters, especially during pregnancy.2,3
Goiters are classified according to how the gland grows, and by whether the thyroid produces excess hormone (toxic goiter) or normal levels of hormone (non-toxic goiter).7
Diffuse goiter
The entire thyroid gland enlarges.1,7
Nodular goiter
Multinodular goiter
What causes a thyroid goiter?
The most common cause worldwide is iodine deficiency1,2,7 — but hyperthyroidism, thyroid inflammation, and thyroid cancer can also drive goiter growth.7
- Iodine deficiency — the most common cause of goiters worldwide.1,2,7
- Hyperthyroidism — including Graves' disease, where the overactive gland enlarges.7
- Thyroid inflammation (thyroiditis) — several types of thyroiditis can cause the gland to swell.7
- Thyroid cancer and other thyroid diseases — malignancy and other disorders can also present as goiter.7
How is a thyroid goiter diagnosed?
Diagnosis starts with a physical exam2 and is refined with ultrasound9 — and CT when a goiter extends toward the chest.2
Diagnosis of a goiter typically begins with a physical examination.2 Nodules larger than 1 cm can generally be felt on examination.2 An ultrasound is used to evaluate the thyroid and can distinguish thyroid nodules from other structures such as lymph nodes and cysts.9 The examination may also assess for deviation of the trachea, and a CT scan may be used to evaluate goiters that extend toward the chest.2
What are the treatment options for a goiter?
Surgery is the traditional gold standard — but it removes the gland and often means lifelong hormone replacement. TAE shrinks the goiter and saves your thyroid.4
The traditional gold standard treatment for goiters is surgery — hemi- or total thyroidectomy.4 The downside of surgical removal is permanent hypothyroidism requiring lifelong thyroid hormone replacement. Surgery also carries risks including nerve injury, electrolyte imbalances, infection, and post-operative complications, especially in older patients.8
Radioactive iodine is another treatment option,4 but it also carries the risk of permanent hypothyroidism.4 Percutaneous ablation may require multiple treatments, and radiofrequency ablation (RFA) is generally suited to only one or two nodules.4 Thyroid artery embolization (TAE) has recently emerged as an effective, minimally invasive, and safer treatment for goiters.4
Embolization (TAE)
- Outpatient, under 1 hour5 — home with a Band-Aid
- No incision, scar, or hospital stay
- Saves your thyroid gland — organ preservation4
- Not known to cause permanent hypothyroidism or hypoparathyroidism4
- Complications largely minor and temporary (neck pain, hoarseness)4
- Minimally invasive, cost-feasible, effective, safer alternative4
Thyroidectomy
- Hemi- or total surgical removal of the thyroid4
- Highly invasive — loss of the organ4
- Permanent hypothyroidism → lifelong hormone replacement4
- Risks: hypoparathyroidism, laryngeal nerve palsy4
- Nerve injury, electrolyte imbalances, infection8
- Post-operative complications, especially in older patients8
Rare major complications of TAE include symptomatic hyperthyroidism and groin hematoma.4 TAE is not known to cause permanent hypothyroidism or hypoparathyroidism — making it a minimally invasive, cost-feasible, effective, and safer alternative to surgery.4
How is thyroid goiter embolization performed?
A tiny catheter, X-ray guidance, and tiny particles placed into one to three thyroid arteries4 — done in under an hour,5 home with a Band-Aid.
Numbing & mild sedation
A local and topical anesthetic and a mild sedative keep you comfortable — no general anesthesia.
Tiny catheter, two access options
Identify the thyroid arteries
Embolize & go home
What are the advantages of TAE?
No major scar, no stitches, no anesthesia risks — and above all, your thyroid gland is saved.
- No major scar
- No hormone replacement
- Fast recovery
- No stitches
- No internal cutting or bleeding
- Saves your thyroid gland
- No anesthesia risks
- Outpatient
- Less risks than surgery
How effective is TAE for a goiter?
Results build month by month — hormones improve by 1 month, volume drops up to 32% by 3 months, symptoms substantially improve by 6 months — with over 98% patient satisfaction.4,10
Hormones improve
Patients show hormone-level improvements and size reduction4,6 — and TAE does not worsen hormone secretion.10
Up to 32% smaller
Goiter volume decreases up to 32%,10 and compression symptoms improve even in the largest goiters.10
Symptoms resolve
Over 98% of patients at six months were satisfied with their TAE outcome and would recommend the treatment.4
What is recovery like after thyroid embolization?
About one day of downtime — home the same day with a short course of antibiotics and pain medication.4
Downtime after thyroid embolization is about one day. Patients may feel soreness in the neck and at the catheter insertion site. TAE is an outpatient procedure, so patients go home the same day with a short course of antibiotics and pain medication.4
TAE or RFA — which is right for your goiter?
RFA is precise heat for one or two large nodules; TAE is diffuse coverage for the whole region — and Dr. Allaei is one of very few physicians experienced in both.
RFA — Radiofrequency Ablation
- Uses a probe to heat and shrink nodular tissue
- Targeted and precise
- Excellent for one or two large nodules
- Not ideal for numerous nodules or disease on both sides
TAE — Thyroid Artery Embolization
- Delivers small beads into the goiter's blood supply
- Treats the whole region more diffusely
- Larger overall effect on the gland
- Well suited to multinodular or bilateral goiters
One consultation, every option — and the hands to deliver any of them
Most centers can offer you only the treatment they happen to perform. Our physician is one of only a few specialists with a background in both RFA and embolization — so the recommendation fits your goiter, not the center's toolkit.
One of very few physicians offering both TAE and RFA
An early TAE adopter — with both tools
Among the first few physicians to begin performing TAE, with years of experience — and one of only a few with a background in both treatments, recommending the right one or a gland-saving combination.
Exceptional wire skills, Mallinckrodt-trained
The catheter-and-wire dexterity thyroid embolization depends on is part training, part innate talent — refined at Washington University’s Mallinckrodt Institute.
Complex-organ embolization depth
A center built for embolization
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Who performs your thyroid goiter embolization?
At CVI Thyroid Center, your TAE procedure is performed by Dr. Atabak Allaei — by the physician, start to finish. He was among the first few physicians to begin performing thyroid artery embolization and already has years of experience with the procedure — making him one of the most experienced and trusted thyroid embolization specialists, and one of very few physicians experienced in both TAE and RFA.
It matters who holds the wire. Embolizing a goiter means steering a hair-thin catheter through small, branching thyroid arteries in the neck — reading a flat, 2D X-ray while navigating a 3D vascular tree, and placing particles only in the vessels feeding the goiter. That level of catheter-and-wire skill is part rigorous training and part innate talent — a steadiness of hand and an ability to visualize the end result that can’t simply be taught. Dr. Allaei refined that aptitude through fellowship training at the prestigious Mallinckrodt Institute of Radiology at Washington University/Barnes-Jewish Medical Center, and through thousands of complex embolizations in high-stakes organs — the uterus, kidney, liver, prostate, and lung — before applying it to the thyroid. He serves on staff at Cedars-Sinai Medical Center in Beverly Hills and UCI Health, and is the Medical Director of California Vascular & Interventional.
Atabak Allaei, MD
Dual board-certified in Vascular & Interventional Radiology and Diagnostic Imaging — a combination that pairs detailed diagnostic interpretation with precise procedural treatment. Fellowship-trained at the Mallinckrodt Institute of Radiology (Washington University/Barnes-Jewish), on staff at Cedars-Sinai and UCI Health, and Medical Director of CVI, he has performed more than 5,000 image-guided procedures. Among the first few physicians to begin performing thyroid artery embolization — with years of TAE experience — and one of very few experienced in both thyroid RFA and embolization, he is respected for his technical skill, careful imaging evaluation, and ability to manage challenging cases. Consultations by telehealth or in person in Los Angeles, California.
Thyroid goiter embolization: common questions
What is a thyroid goiter?
A goiter is an enlargement of the thyroid gland. It can affect both men and women, though women carry a higher risk, especially during pregnancy. Goiters are classified by growth pattern — diffuse (the whole gland enlarges), nodular (a single nodule), or multinodular (multiple nodules) — and by hormone status as toxic (producing excess thyroid hormone) or non-toxic (normal hormone levels).
What causes a thyroid goiter?
Common causes include iodine deficiency (the most common cause worldwide), hyperthyroidism such as Graves’ disease, thyroid inflammation (thyroiditis), and thyroid cancer or other thyroid diseases.
What is thyroid artery embolization (TAE)?
TAE is a non-surgical, outpatient treatment that shrinks a goiter by blocking its blood supply. Through a tiny catheter, an interventional radiologist places tiny particles into one to three arteries feeding the thyroid; the particles embed in the nodular tissue and the goiter shrinks. Unlike surgical removal, TAE preserves the thyroid gland — it is not known to cause permanent hypothyroidism or hypoparathyroidism, so patients avoid lifelong hormone replacement.
How is thyroid goiter embolization performed?
TAE is performed in under an hour as an outpatient procedure by a trained vascular and interventional radiologist. A tiny catheter is placed in an artery at the top of the leg (femoral approach) or the lower arm (radial approach); under X-ray guidance the physician identifies the thyroid arteries and treats one to three of them with tiny particles. A local and topical anesthetic and a mild sedative keep it comfortable. There is no major incision, scar, or hospital stay — patients go home the same day with a Band-Aid.
How effective is TAE for a thyroid goiter?
Improvements build over months: within one month, patients show hormone-level improvements and size reduction, and TAE does not worsen hormone secretion. By three months, goiter volume decreases up to 32%, and compression symptoms improve even in the largest goiters. By six months, patients report substantial symptom improvement and normalization of hyperthyroidism. More than 98% of patients at six months were satisfied and would recommend TAE.
What is recovery like after thyroid embolization?
Downtime is about one day. Patients may feel soreness in the neck and at the catheter insertion site. TAE is an outpatient procedure, so patients go home the same day with a short course of antibiotics and pain medication.
Is TAE safer than goiter surgery?
Surgery (hemi- or total thyroidectomy) is the traditional gold standard but is highly invasive and results in loss of the thyroid, with risks including hypoparathyroidism, laryngeal nerve palsy, and permanent hypothyroidism requiring lifelong hormone replacement, plus infection and post-operative complications — especially in older patients. TAE complications are largely minor, such as temporary neck pain or hoarseness; major complications like symptomatic hyperthyroidism or groin hematoma are rare. TAE is not known to cause permanent hypothyroidism or hypoparathyroidism, making it a minimally invasive, cost-feasible, effective, and safer alternative.
Which is better for a goiter — TAE or RFA?
They suit different goiters. RFA uses a probe to heat nodular tissue — precise and excellent for one or two large nodules, but not ideal for numerous nodules or disease on both sides. TAE delivers small beads into the blood supply, treating the whole region more diffusely with a larger overall effect — well suited to multinodular or bilateral goiters. Dr. Allaei is one of very few physicians experienced in both treatments, and sometimes uses a combination approach to save the gland; a consultation determines which is best for your specific goiter.
- Saran, S., 2020. Multinodular goiter. In Goiter-Causes and Treatment. IntechOpen.
- Medeiros-Neto, G., 2016. Multinodular goiter. Endotext [Internet].
- Kung, A.W.C., Chau, M.T., Lao, T.T., Tam, S.C.F. and Low, L.C.K., 2002. The effect of pregnancy on thyroid nodule formation. The Journal of Clinical Endocrinology & Metabolism, 87(3), pp.1010-1014.
- 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.
- Dedecjus, M., Tazbir, J., Kaurzel, Z., Stróżyk, G., Zygmunt, A., Lewiński, A. and Brzeziński, J., 2009. Evaluation of selective embolization of thyroid arteries (SETA) as a preresective treatment in selected cases of toxic goitre. Thyroid Research, 2(1), pp.1-7.
- en Oz, G., Cander, S., Sisman, P., Cosar, A., Ersoy, C. and Erturk, E., 2018, May. Thyroid arterial embolization for the treatment of large multinodular goiter and hyperthyroidism. In Endocrine Abstracts (Vol. 56). Bioscientifica.
- Can, A.S. and Rehman, A., 2020. Goiter. In StatPearls [Internet]. StatPearls Publishing.
- Finnerty, B.M., Gray, K.D., Ullmann, T.M., Zarnegar, R., Fahey, T.J. and Beninato, T., 2020. Frailty is more predictive than age for complications after thyroidectomy for multinodular goiter. World Journal of Surgery, 44, pp.1876-1884.
- Hegedüs, L., 2001. Thyroid ultrasound. Endocrinology and Metabolism Clinics of North America, 30(2), pp.339-360.
- Kaminski, G., Jaroszuk, A., Zybek, A., Brzozowski, K., Piasecki, P., Ziecina, P. and Ruchala, M., 2014. The calcium–phosphate balance, modulation of thyroid autoimmune processes and other adverse effects connected with thyroid arterial embolization. Endocrine, 46, pp.292-299.
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.
Explore more thyroid treatments
Large Nodule RFA
Heat-based ablation for one or two large nodules.
Toxic Nodule RFA
RFA for overactive (toxic) nodules.
Thyroid Cancer RFA
Ablation for recurrent and primary thyroid cancer.
Parathyroid Adenoma RFA
Non-surgical treatment for parathyroid adenomas.
Treatment Comparison
RFA vs. embolization vs. surgery vs. iodine.
Meet Our Specialist
The physician who performs your procedure.
Don't wait for your goiter to get larger
A growing goiter only gets harder to treat — and surgery costs you the gland. Request a consultation and Dr. Allaei will review your imaging, labs, and history, weigh TAE, RFA, or a gland-saving combination, and explain the realistic outcomes before any decision is made. Consultations available via telehealth or in person in Los Angeles, California.
