Safety of radiofrequency ablation in patients with hyperparathyroidism: a 10-year real-world multicenter experience.

BACKGROUND

US-guided percutaneous radiofrequency ablation (RFA) is a validated procedure for hyperparathyroidism (HPT). However, it is associated with potentially significant complications, and data regarding the incidence and risk factors associated with RFA-related complications are limited.

OBJECTIVE

To assess the complication rates associated with RFA for HPT and identify the potential influential factors.

METHODS

This retrospective study was to investigate the associated complications in HPT patients who underwent RFA between January 2013 and April 2024. We collected and analyzed complications for these patients, focusing on their categories and rates. Logistic regression analysis was used to assess the crucial factors.

RESULTS

Three hundred twenty patients were included, including 117 cases of primary hyperparathyroidism (pHPT) and 203 cases of secondary hyperparathyroidism (sHPT). The overall complication rate was 22.2% (71/320), with 9.4% (30/320) being major complications and 14.7% (47/320) minor complications. Six patients experienced both major and minor complications. Among sHPT patients, 54 cases (26.6%, 54/203) experienced complications, including 22 major cases and 36 minor cases; however, among pHPT patients, 17 cases experienced complications (14.5%, 17/117), with 8 being major and 11 being minor. sHPT was identified as a risk factor for overall complications (odds ratio, 2.132; p = 0.014) and minor complications (odds ratio, 2.077; p = 0.046). Maximum diameter was the only risk factor for major complications (odds ratio, 1.508, p = 0.047).

CONCLUSIONS

RFA is a well-tolerated technique with an acceptably low incidence of major complications for HPT. Enhanced management strategies involving patients with sHPT and large hyperplastic glands may help mitigate complications.

KEY POINTS: Question Is ultrasound-guided RFA a safe nonsurgical alternative to traditional parathyroidectomy for patients with pHPT and sHPT who require intervention? Findings Ultrasound-guided RFA is a safe procedure for treating HPT. However, patients with sHPT and large hyperplastic glands are more likely to develop complications. Clinical relevance RFA is a well-accepted technique with a relatively low complication rate and can be used as a non-surgical alternative in the management of HPT.