North American Society for Interventional Thyroidology (NASIT) Statement on the Use of Embolization for the Management of Thyroid Disease.

Thyroid artery embolization (TAE) is an emerging minimally invasive treatment for benign and select malignant thyroid diseases. This review summarizes current evidence and presents expert consensus recommendations from the North American Society for Interventional Thyroidology regarding patient selection, indications, technique, safety, outcomes, and the role of TAE in contemporary thyroid disease management. Recommendations were developed through multidisciplinary expert review of the literature, including comparisons with surgery, thermal ablation, and radioactive iodine therapy. TAE is particularly effective for large-volume thyroid disease (>30 mL nodules and >50 mL goiters) and substernal extension, achieving 32% to 73% volume reduction at 6 months with improvement in compressive symptoms and cosmesis. In Graves disease and toxic multinodular goiter, euthyroidism rates exceed 70%, with reported durability up to 50 months. Preoperative TAE may reduce operative time and blood loss. Most adverse events are mild and self-limited, and serious complications are rare. TAE represents a safe and effective option for selected patients with symptomatic thyroid disease and may also have roles in hyperthyroidism and preoperative management. Further studies are needed to standardize technique and define its position relative to established therapies.