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经桡动脉途径对大型有症状的孤立性良性甲状腺结节进行甲状腺动脉栓塞术。

Thyroid artery embolization of large solitary symptomatic benign thyroid nodules through transradial approach.

作者信息

Cheng Kai-Lun, Liang Keng-Wei, Lee Hsiang-Lin, Wang Hui-Yu, Shen Chao-Yu

机构信息

Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung.

School of Medicine, Chung Shan Medical University, Taichung.

出版信息

Quant Imaging Med Surg. 2023 Aug 1;13(8):5355-5361. doi: 10.21037/qims-22-1385. Epub 2023 May 30.

Abstract

This study investigated the efficacy and safety of transradial access (TRA) thyroid artery embolization (TAE) for patients with large solitary symptomatic benign thyroid nodules. Six patients with a total of six nodules (three men and three women; mean age, 36.3 years; age range, 23-45 years) underwent TRA TAE between October 2021 and June 2022 and were subsequently followed up three months later, and their cases were retrospectively reviewed. The associated complications were recorded during and after TRA TAE. The volume change and nodule-related symptom score on a 10-cm visual analogue scale (VAS) between baseline, 1- and 3-month follow-up was analyzed using Wilcoxon signed-rank test. The technical success rate of the TRA TAE was 100% without conversion to transfemoral access. The mean volume of the nodules decreased between baseline (84.1 mL; range, 46.1-170.5 mL), 1-month (38.8 mL; range, 17.6-91.5 mL; P=0.028) and 3-month (14.8 mL; range, 3.95-26.4 mL; P=0.068) at follow-up after TRA TAE. The mean volume reduction rate was 54.9% (range, 45.2-71.8%) at 1-month follow-up and 81.8% (range, 62.0-92.0%) at 3-month follow-up. The VAS score was reduced at 1-month (P=0.028) and at 3-month follow up (P=0.068). Radial artery spasm (n=1) was noted during TRA TAE, and neck pain (n=5) and voice change (n=1) occurred within 1 week after the procedure and resolved with conservative treatment. No major complications were reported. TRA TAE may be a promising alternative therapy for the management of large solitary thyroid nodules.

摘要

本研究调查了经桡动脉途径(TRA)甲状腺动脉栓塞术(TAE)治疗有症状的大型孤立性良性甲状腺结节患者的疗效和安全性。2021年10月至2022年6月期间,6例共有6个结节的患者(3例男性和3例女性;平均年龄36.3岁;年龄范围23 - 45岁)接受了TRA TAE治疗,随后在3个月后进行随访,并对其病例进行回顾性分析。TRA TAE期间及之后记录相关并发症。使用Wilcoxon符号秩检验分析基线、1个月和3个月随访时10厘米视觉模拟量表(VAS)上的体积变化和结节相关症状评分。TRA TAE的技术成功率为100%,无需转为经股动脉途径。TRA TAE术后随访时,结节平均体积在基线时为84.1毫升(范围46.1 - 170.5毫升),1个月时为38.8毫升(范围17.6 - 91.5毫升;P = 0.028),3个月时为14.8毫升(范围3.95 - 26.4毫升;P = 0.068)。1个月随访时平均体积缩小率为54.9%(范围45.2 - 71.8%),3个月随访时为81.8%(范围62.0 - 92.0%)。VAS评分在1个月(P = 0.028)和3个月随访时(P = 0.068)降低。TRA TAE期间发现1例桡动脉痉挛,术后1周内发生5例颈部疼痛和1例声音改变,经保守治疗后缓解。未报告重大并发症。TRA TAE可能是治疗大型孤立性甲状腺结节的一种有前景的替代疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/10423340/3f02ddecf011/qims-13-08-5355-f1.jpg

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