Improved Sealed Venous Indwelling Needle in Ultrasound-Guided Thyroid Cyst Puncture Sclerotherapy: Characteristics and Applications.

Abstract

Objective: To assess the safety and efficacy of an improved sealed venous indwelling needle for ultrasound-guided sclerotherapy of thyroid cysts in comparison with the standard percutaneous transhepatic cholangiography (PTC) needles.

Methods: Two trapezoidal incisions (2 mm in topline, 1 mm in baseline, and 1 mm in height) were made along the needle core groove at the soft distal end of a sealed venous indwelling needle to create a novel open-window sealed venous indwelling needle. To evaluate the efficacy and safety of this improved needle, we conducted a prospective cohort study with a historical control group, comparing the improved needle with standard 21-gauge PTC needles in the treatment of 68 cystic thyroid nodules. Key outcomes included technical success, which encompasses successful needle placement, complete aspiration, and sclerosant delivery, as well as a reduction in cyst volume at the 3-month follow-up, and procedural outcomes, complications (bleeding, infection, and extravasation), procedural pain, and patient satisfaction (assessed using a 5-point Likert scale).

Results: Sixty-eight cysts in 52 patients (median age, 54 years) were treated. Technical success was achieved in 94.1% (32/34) procedures versus 87.5% (28/34) in the PTC needle cohort (p = 0.27). The mean cyst volume reduction was 82.51% (range, 52%-100%) at 3 months. Complications occurred in 3 (two hematomas and one transient hyperthyroidism), with no infections or nerve injury. Patient-reported pain scores were 1 (IQR 1-2) and dropped by 43%. Overall satisfaction was 97% (66/68). The improved sealed venous indwelling needle was significantly superior to the PTC needle in terms of procedural pain, comfort, complication rate, and overall patient experience (p < 0.05), whereas no statistically significant differences were observed in recovery speed, involution efficacy, operator skill, or communication clarity (p ≥ 0.05).

Conclusion: The improved sealed venous indwelling needle provides higher technical success, greater cyst volume reduction, fewer complications, and less pain than PTC needles, offering a safer and more effective alternative for ultrasound-guided thyroid cyst sclerotherapy.