The Analysis Of Factors Affecting The Effect Of Thyroid Arterial Embolisation To Treat Hyperthyroidism Caused By Graves' Disease

Objective To investigate the multiple factors which may affect the mid-or long-term clinical effect of thyroid arterial embolisation to treat hyperthyroidism caused by Graves' disease. Materials and Methods 1. Twenty-eight patients of hyperthyroidism caused by Graves' disease had been treated through transcathter arterial embolisation and followed up mid-or long-term. 2. The thyroid angiograghy, the interventional embolisation and its clinical effect of the 28 patients were investigated. 3. Multiple factors which may affect the clinical effect were analysed such as the patients' thyroid tumefaction, the immune state and the serum thyroid hormone level before embolisation, the lateral circulation, the embolised rang, level and extent of the thyroid arteries embolised and the complications. Results Mid-term effect was good. After embolisation, twenty-three patients' symptoms and signs of hyperthyroidism disappeared or improved greatly with 16 cured and 7 improved. Four cases were recurrent and one had brain infarction and died because of hyperthyroidism crisis caused by brain infarction. Conclusion 1. The thyroid arterial embolisation has clinical efficiency on all the patients by short-term with the recurrent rate of one year being 14.2%. The mid-term rate of efficiency is 82.1%; 2. The clinical effect of embolising three thyroid arteries is better than that of embolising two arteries and at least three arteries shold be managed to be embolised; 3. It is further justified that the thyroid embolisation should be at-2-the level of capillary and lobular arteries and that the embolisation of pure trunk of thyroid artery has not much significance. The size of embolism agents is also made clear, that is to use the smallest particles of 150-250um as the mam embolism agents so as to get better embolisation efficacy; 4. It is proved that when embolising, the combined use of papaverine and pingyangmycin can enhance the occlusion of terminal circulation and capillary of the thyroid and improve the clinical effect greatly; 5. The formation of lateral circulation is one of the main factors of post-embolisation hyperthyroidism reccurency and the importance and methods are investigated to prevent the formation of lateral circulation. 6. The relationship is cleared between serum thyroid hormone level, etc. before embolisation and the clinical effect of embolisation; 7. The importance and methods are put foreward of how to avoid regurgitation of embolism agents and of how to avoid misembolisation.