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ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 1  |  Page : 15-18

Effectiveness of percutaneous ethanol injection therapy compared to parathyroidectomy in the management of secondary and tertiary hyperparathyroidism


Department of Radiology, Chiang Mai University, Chiang Mai, Thailand

Correspondence Address:
Dr. Inmutto Nakarin
Department of Radiology, Chiang Mai University, Chiang Mai
Thailand
Pochan Prach
Department of Radiology, Chiang Mai University, Chiang Mai
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AJIR.AJIR_37_18

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Background: Secondary hyperparathyroidism (SHPT) and tertiary hyperparathyroidism (THPT) are a common complication of chronic renal failure. Percutaneous ethanol injection therapy (PEIT) has been used as alternative to surgery, but its effectiveness is inconsistent. Objectives: The objective of the study is to evaluate the effectiveness of PEIT in the management of patients with SHPT and THPT. Materials and Methods: Ninety-one patients with chronic renal failure and SHPT or THPT were treated with PEIT (n = 55) and surgery (n = 36) between January 2006 and July 2015. The medical records, imaging studies, and ablation techniques were reviewed to assess the efficacy of each treatment modality and complications. Results: Parathyroid hormone (PTH) level after treatment <160 pg/mL was used to indicate success of treatment. PEIT showed lower effectiveness compared to surgery (1.8% vs. 61.1%). There was no complication in PEIT group. Symptomatic hypocalcemia was found 11.1% in surgery group. Conclusion: PEIT in treatment of secondary and THPT was much less effective than surgery due to large nodule sizes, high levels of PTH, and multiple parathyroid nodules.


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