Rostov State Medical University (Kafedra, docent)
Russian Federation
Russian Federation
from 01.01.2019 until now
Russian Federation
Surgical treatment of diffuse toxic goiter (DTG) is associated with significant risks, including considerable intraoperative blood loss and potential damage to vital anatomical structures. Selective intra-arterial embolization (SAE) is a promising method for preoperative preparation aimed at reducing these risks. Goal. To evaluate the volume of intraoperative blood loss and the risk of related complications in patients with diffuse toxic goiter using selective intra-arterial embolization before thyroidectomy. Material and Methods. The study included 34 patients with DTG who underwent SAE prior to thyroidectomy. Ultrasound was used to assess thyroid gland volume and blood flow velocity before and after embolization. Intraoperative blood loss and postoperative complications were analyzed. Results. SAE significantly reduced the volume of the thyroid gland and decreased blood flow velocity in its arteries. This led to a marked reduction in intraoperative blood loss. The frequency of complications was low: severe postoperative complications, such as recurrent laryngeal nerve palsy and hypoparathyroidism, were rare. Discussion. The results demonstrate that the reduction in blood flow velocity following SAE is a key factor in decreasing intraoperative blood loss and complications. These findings align with data from the literature and underscore the importance of using SAE in clinical practice. However, further research with larger patient cohorts is necessary to comprehensively evaluate the method. Conclusion. SAE is an effective method of preoperative preparation, significantly reducing surgical risks in patients with DTG. Its use improves conditions for thyroidectomy, minimizing intraoperative blood loss and the frequency of complications.
diffuse toxic goiter, thyroid artery embolization, intraoperative blood loss, preoperative preparation, thyroidectomy.
1. Witczak J. K., Ubaysekara N., Ravindran R., Rice S., Yousef Z., Premawardhana L. D. Significant cardiac disease complicating Graves’ disease in previously healthy young adults. Endocrinol Diabetes Metab Case Rep.
2. Babenko A. Y., Grineva E. N., Solntsev V. N. Atrial fibrillation in thyrotoxicosis – determinants of development and persistence. Clinical and Experimental Thyroidology. 2013;9(1):29-37. doihttps://doi.org/10.14341/ket20139129-37.
3. Savitskaya D. A., Babenko A. Y., Derevitskiy I. V., Khushkina A. Y. The contribution of various factors to the development of atrial fibrillation in thyrotoxicosis. Proceedings of the VIII (XXVI) National Congress of
4. Busenbark L. A., Cushnie S. A. Effect of Graves’ disease and methimazole on 2025, 28, № 1warfarin anticoagulation. Ann Pharmacother. 2006;40(6):1200–1203. doi:https://doi.org/10.1345/aph.1G422.
5. Babenko A. Y. Thyrotoxic cardiomyopathy: risk factors and predictors of development. Reviews in Clinical Pharmacology and Drug Therapy. 2011;9(3):49-59.
6. Tuchalova A. I. T., Magomedov A. G., Abdulkhalikov A. S., Akhmedov I. G. Cardioversion for atrial fibrillation caused by toxic goiter and moderate general hypothermia in toxic goiter surgery. Bulletin of the Dagestan State
7. Naser J., Pislaru S. V., Stan M. N., Lin G. Atrial fibrillation in patients with Graves’ disease: incidence, risk factors, and outcomes. European Heart Journal. 2022;43(Supplement_2):ehac544.371.
8. Yamanouchi K., Minami S., Hayashida N., Sakimura C., Kuroki T., Eguchi S. Predictive factors for intraoperative excessive bleeding in Graves’ disease. Asian J Surg. 2015;38(1):1-5. doihttps://doi.org/10.1016/j. asjsur.2014.04.007.
9. Lebedeva D. V., Ilicheva E. A., Grigoryev E. G. Modern aspects of surgical treatment of diffuse toxic goiter. Siberian Medical Journal (Irkutsk). 2019;3.
10. Toleutaev T. A. Modern surgical methods for treating patients with diffuse toxic goiter. Global Science and Innovations: Central Asia. 2021;2(12):11-13.
11. Ryzhenkova E. M., Bryzgalina S. M., Maklakova T. P., et al. Selective embolization of thyroid arteries as a method of preoperative preparation in patients with diffuse toxic goiter. Proceedings of the VIII (XXVI) National
12. Tartaglia F., Sorrenti S., Maturo A., Ulisse S. Selective embolization of the thyroid arteries (SETA): Ten years’ experience. Asian J Surg. 2019;42(8):847848. doi:https://doi.org/10.1016/j.asjsur.2019.05.008.
13. Ducloux R., Sapoval M., Russ G. Embolization of thyroid arteries in a patient with compressive intrathoracic goiter ineligible for surgery or radioiodine therapy. Ann Endocrinol (Paris). 2016;77(6):670-674.
14. Bonnici M., Nevin C., Boo S. Thyroid ima artery embolization for the treatment of Graves’ disease and thyroid storm. Radiol Case Rep. 2023;18(8):2641–2644. doihttps://doi.org/10.1016/j. radcr.2023.04.044.
15. Sugino K, Ito K, Nagahama M, Kitagawa W, Shibuya H, Ito K. Surgical management of Graves’ disease -10-year prospective trial at a single institution. Endocr J. 2008 Mar;55(1):161-7. doihttps://doi.org/10.1507/endocrj.k07e-013.



