About Radiofrequency Ablation (RFA)
Radiofrequency ablation is designed to destroy thyroid nodules while minimizing collateral damage to thyroid tissue. The radio waves heat the nodule tissue and break it down. The nodule will shrink over the next 3-6 months.
Important Eligibility Criteria
- RFA can be used on patients only after confirming a nodule is benign with at least 1 biopsy.
- You CANNOT have RFA if you have:
- A bleeding disorder
- A pacemaker/defibrillator
- Are pregnant
Pre-Procedure Instructions
- Stop aspirin 1 day prior to RFA.
- If you take blood thinners, check with your prescriber if it’s OK to stop them for 3 days before RFA and restart them 2 days afterward.
- If you choose to use Xanax, you MUST have someone to drive you home.
- Wear loose fitting clothing, ideally gym shorts and a T-shirt.
Procedure Details
- The procedure is done in the office.
- Local anesthetic (lidocaine) will be used on the thyroid gland, so you will feel pressure during the procedure, but no pain.
What to Expect
- Final informed discussion with your physician about risks/benefits/alternatives, and goals.
- Change into a gown for easy access to neck and shoulders.
- Lie on the table with a pillow under your shoulders to help extend the neck.
- Skin will be cleansed with sterilizing liquid under sterile technique.
- Ultrasound will guide optimal placement of the RFA probe.
- Lidocaine will be injected at the skin and around the thyroid.
- When the probe is activated, you might hear and feel some “popping” sensations, like popcorn.
- After full ablation, the probe is withdrawn and pressure applied to minimize bleeding.
After the Procedure
- Observed in the office for 15-30 minutes.
- Apply ice pack to minimize swelling:
- On for 20 minutes
- Off for 20 minutes while awake
- Normal to have bruising that resolves in 1-3 days.
- Pain management:
- Day 1: Tylenol recommended
- Afterward: Ibuprofen can help with swelling
Important Cautions
- If breathing becomes difficult, go to the ER immediately.
- Notify the clinic if:
- Pain becomes significant
- Swelling significantly worsens
- New bruise develops at the probe site
Follow-up
- Office check at:
- 1 week after procedure
- 3 months after procedure