BackTable Vascular & Interventional Ep. 587 Thyroid Artery Embolization: Indications & Outcomes with Dr. Juan Camacho
Nov 7, 2025
Dr. Juan Camacho, an interventional radiologist from Sarasota, discusses the innovative technique of thyroid artery embolization and its transformative role in thyroid cancer care. He shares insights from his multidisciplinary program at Memorial Sloan Kettering, emphasizing collaboration and patient selection criteria. Key procedural techniques, including catheter choice and the use of cone-beam CT for precision, are explored. Dr. Camacho also highlights remarkable outcomes, including significant reductions in thyroid volume and improved patient quality of life, with low rates of hypothyroidism.
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Building A Thyroid Program From Scratch
- At Memorial Sloan Kettering Dr. Juan Camacho helped build a thyroid disease management team that moved from animal models to clinical micropapillary ablation.
- That program grew from palliative embolizations for anaplastic thyroid cancer into broader malignant and benign thyroid work.
Where Embolization Fits In Care
- Embolization fills the treatment gap between observation, ablation, and surgery for large or vascular thyroid disease.
- Embolization is better suited than ablation for larger volumes because of heat-sink and high recurrence after ablation above modest sizes.
Strict Patient Selection Criteria
- Only treat benign cytology nodules (Bethesda II, and Bethesda III with molecular testing) when considering embolization.
- Use volume cutoffs: >30 mL for nonfunctional nodules and >15 mL for autonomously functioning nodules to favor embolization over ablation.