Embolization of Thyroid Arteries as a Bridge Therapy Before Thyroidectomy in a Patient With Thyrotoxicosis: Case Report
- 1Department of Internal Medicine Universidad Industrial de Santander Bucaramanga Santander Colombia uis.edu.co
Abstract
Thyroid artery embolization (TAE) is a minimally invasive technique that induces selective ischemic necrosis of the thyroid parenchyma, thereby reducing thyroid hormone synthesis with few associated complications. Successful cases of TAE as a bridge therapy before total thyroidectomy in patients with refractory thyrotoxicosis are rare. We present the case of a 36‐year‐old man with a history of Graves’ disease and poor adherence to medical therapy who presented with clinical features of thyrotoxicosis. On physical examination, he exhibited active moderate‐to‐severe orbitopathy (EUGOGO classification; clinical activity score 5/7) and a grade III goiter, reflecting advanced and poorly controlled disease. Paraclinical findings revealed markedly elevated free T4 levels and suppressed TSH. The diagnosis of uncontrolled hyperthyroidism was made, with a Burch–Wartofsky score of 40 points, indicating an impending thyroid storm. Medical therapy at maximally tolerated doses did not result in a complete clinical response; therefore, a total thyroidectomy was planned, preceded by therapeutic plasma exchange (TPE). Due to intolerance to TPE, TAE was performed as a bridge therapy, followed by total thyroidectomy without complications. The patient was discharged with a resolution of symptoms and progressive normalization of thyroid hormone levels. TAE may represent a valuable bridging therapy before total thyroidectomy in selected patients with severe thyrotoxicosis due to Graves’ disease who are refractory to or unsuitable for conventional therapies.
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BibTeX
@article{gomezfontalvo2026embolization,
title = {{Embolization of Thyroid Arteries as a Bridge Therapy Before Thyroidectomy in a Patient With Thyrotoxicosis: Case Report}},
author = {Cesar Alfonso Gomez-Fontalvo and Silvia Alejandra Díaz–Jaimes and María Paula Rangel–Villamizar and Diego Augusto Moreno-Diaz and Rafael Castellanos-Bueno},
journal = {Case Reports in Endocrinology},
year = {2026},
month = oct,
doi = {10.1155/crie/8194736},
url = {https://doi.org/10.1155/crie/8194736},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Embolization of Thyroid Arteries as a Bridge Therapy Before Thyroidectomy in a Patient With Thyrotoxicosis: Case Report
AU - Cesar Alfonso Gomez-Fontalvo
AU - Silvia Alejandra Díaz–Jaimes
AU - María Paula Rangel–Villamizar
AU - Diego Augusto Moreno-Diaz
AU - Rafael Castellanos-Bueno
PY - 2026
DA - 2026/10/26
JO - Case Reports in Endocrinology
DO - 10.1155/crie/8194736
UR - https://doi.org/10.1155/crie/8194736
AB - Thyroid artery embolization (TAE) is a minimally invasive technique that induces selective ischemic necrosis of the thyroid parenchyma, thereby reducing thyroid hormone synthesis with few associated complications. Successful cases of TAE as a bridge therapy before total thyroidectomy in patients with refractory thyrotoxicosis are rare. We present the case of a 36‐year‐old man with a history of Graves’ disease and poor adherence to medical therapy who presented with clinical features of thyrotoxicosis. On physical examination, he exhibited active moderate‐to‐severe orbitopathy (EUGOGO classification; clinical activity score 5/7) and a grade III goiter, reflecting advanced and poorly controlled disease. Paraclinical findings revealed markedly elevated free T4 levels and suppressed TSH. The diagnosis of uncontrolled hyperthyroidism was made, with a Burch–Wartofsky score of 40 points, indicating an impending thyroid storm. Medical therapy at maximally tolerated doses did not result in a complete clinical response; therefore, a total thyroidectomy was planned, preceded by therapeutic plasma exchange (TPE). Due to intolerance to TPE, TAE was performed as a bridge therapy, followed by total thyroidectomy without complications. The patient was discharged with a resolution of symptoms and progressive normalization of thyroid hormone levels. TAE may represent a valuable bridging therapy before total thyroidectomy in selected patients with severe thyrotoxicosis due to Graves’ disease who are refractory to or unsuitable for conventional therapies.
SN - 2090-6501
SN - 2090-651X
ER -