Ethanol Ablation Thyroid Complex Cysts Basics 101: How is it done?

Ethanol Ablation Thyroid Complex Cysts Basics 101: How is it done?

Ethanol Ablation Thyroid Complex Cysts Basics 101: How is it done?

Ethanol Ablation PEI of Thyroid Complex Cysts and solid Thyroid Basics 101: How is it done?

Richard Guttler MD,FACE,ECNU

The recommended PEI basic technique from the Korean thyroid ablation specialists.

  1. Ethanol ablation uses a high concentration (95–99%) of ethanol.
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  3. The skin is punctured with a 16–21-gauge needle, and the target nodule is approached through the thyroid isthmus to prevent ethanol leakage during the procedure.moving-shot
  4. The method of ethanol instillation depends on the solid component of the nodule.
  5. For a cystic or predominantly cystic nodule, the tip of the needle is inserted into the center of the cyst, as much fluid as possible is aspirated, and then ethanol is injected.
  6. If the cyst contents are viscous, the fluid is aspirated using a large-bore needle, followed by irrigation with normal saline to remove internal debris and colloid material before ethanol instillation.
  7. The volume of ethanol injected is usually 50% of the aspirated fluid volume. After 2 minutes of ethanol retention with the needle in place, the injected ethanol is removed completely and the needle is withdrawn.
  8. If a predominantly solid nodule contains a cystic component, the latter is punctured, almost completely aspirated, and an appropriate amount of ethanol is instilled.
  9. The tip of the needle is subsequently inserted into the solid component of the target nodule, followed by infusion of an appropriate volume of ethanol.
  10. That volume is based on nodule size and echogenicity of the solid portion.
  11. In treating a purely solid nodule, ethanol is injected directly into the nodule.
  12. Adequate coverage of the target nodule, as indicated by its echogenicity (called intranodular echo-staining), is achieved by adjusting the injection of ethanol under US guidance.
  13. After injection, the needle is rapidly withdrawn.

Ethanol ablation PEI  is available in the USA for cysts,cystic/solid nodules, and cancer lymph nodes.Also as alternative to surgery or active surveillance for micro-papillary cancers.

Call Matt at 310-393-8860 or email to for details.

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