Download PDF
Nuklearmedizin 2023; 62(01): 34-37
DOI: 10.1055/a-1972-9372
Original Article

Adverse events unlikely after fine-needle aspiration biopsies of thyroid nodules in patients on low-dose aspirin: a prospective controlled systematic single center analysis

Unwahrscheinliches Auftreten von unerwünschten Ereignissen nach Feinnadelbiopsien von Strumaknoten bei Patienten mit einer Niedrigdosismedikation von Aspirin: eine prospektive, kontrollierte und systematische Single-Center-Studie
Michael Cordes
1   Nuklearmedizin, Radiologisch-Nuklearmedizinisches Zentrum, Nuremberg, Germany
2   Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Erlangen, Germany
,
Theresa Ida Götz
3   Department of Industrial Engineering and Health, Technical University Amberg-Weiden, Institute of Medical Engineering, Weiden, Germany
,
Torsten Kuwert
2   Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Erlangen, Germany
,
Christian Schmidkonz
2   Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Erlangen, Germany
3   Department of Industrial Engineering and Health, Technical University Amberg-Weiden, Institute of Medical Engineering, Weiden, Germany
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Aim Our aim was to test the assertion that in terms of rate or severity level, adverse events (AEs) after fine-needle aspiration biopsies (FNABs) of thyroid nodules are unfazed by daily low-dose (100 mg) aspirin (acetylsalicylic acid, ASA) intake.

Methods We selected 268 patients for study, grouped as ASA-treated (PASA, n=78) or control (PCtrl, n=190) subjects. Controls received no antithrombotic medication. AE rates and severities were then analyzed based on patient- and nodule-related factors. We also compared group rates of non-diagnostic cytology results.

Results AEs arising after FNABs (PASA, 5%; PCtrl, 8%) did not differ significantly by group in rate (p=0.4873) or severity level (p=0.3399). All were classifiable as minor incidents, none warranting any intervention.

Conclusions The data from the present study suggest, AEs after FNABs of thyroid nodules seldom occur and qualify as minor incidents. Such procedures may be safely conducted in patients taking daily low-dose ASA. There is no evidence to support preemptive therapeutic withdrawal.

Keywords

thyroid nodules - fine-needle aspiration biopsy - acetylsalicylic acid - ASA - antithrombotic agent


Publication History

Received: 18 August 2022

Accepted after revision: 21 September 2022

Article published online:
09 January 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Baloch ZW, Cibas ES, Clark DP. et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal 2008; 5: 6
    CrossrefPubMedSearch in Google Scholar
  • 2 Polyzos SA, Anastasilakis AD. Systematic review of cases reporting blood extravasation-related complications after thyroid fine-needle biopsy. J Otolaryngol Head Neck Surg 2010; 39: 532-541
    PubMedSearch in Google Scholar
  • 3 Lee YH, Baek JH, Jung SL. et al. Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the Korean Society of Thyroid Radiology. Korean J Radiol 2015; 16: 391-401
    CrossrefPubMedSearch in Google Scholar
  • 4 Kim DW, Choo HJ, Park JS. et al. Ultrasonography-guided fine-needle aspiration cytology for thyroid nodules: an emphasis on one-sampling and biopsy techniques. Diagn Cytopathol 2012; 40: E48-E54
    CrossrefPubMedSearch in Google Scholar
  • 5 Perros P, Boelaert K, Colley S. et al. Guidelines for the management of thyroid cancer. Clin Endocrinol 2014; 81: 1-122
    CrossrefPubMedSearch in Google Scholar
  • 6 Abu-Yousef MM, Larson JH, Kuehn DM. et al. Safety of ultrasound-guided fine needle aspiration biopsy of neck lesions in patients taking antithrombotic/anticoagulant medications. Ultrasound Q 2011; 27: 157-159
    CrossrefPubMedSearch in Google Scholar
  • 7 Cordes M, Schmidkonz C, Horstrup K. et al. Fine-needle aspiration biopsies of thyroid nodules: Systematic analysis of adverse events and possible predisposing risk factors. Nuklearmedizin 2018; 57: 211-215
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Feldkamp J, Führer D, Luster M. et al. Fine needle aspiration in the investigation of thyroid nodules. Dtsch Arztebl Int 2016; 113: 353-359
    CrossrefPubMedSearch in Google Scholar
  • 9 Gharib H, Papini E, Garber JR. et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules -- 2016 Update. Endocr Pract 2016; 22: 622-639
    CrossrefPubMedSearch in Google Scholar
  • 10 Haugen BR, Alexander EK, Bible KC. et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26: 1-133
    Search in Google Scholar
  • 11 Regitz-Zagrosek V, Kararigas G. Mechanistic Pathways of Sex Differences in Cardiovascular Disease. Physiol Rev 2017; 97: 1-37
    CrossrefPubMedSearch in Google Scholar
  • 12 Lyle MA, Dean DS. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules in patients taking novel oral anticoagulants. Thyroid 2015; 25: 373-377
    CrossrefPubMedSearch in Google Scholar
  • 13 Hor T, Lahiri SW. Bilateral thyroid hematomas after fine-needle aspiration causing acute airway obstruction. Thyroid 2008; 18: 567-569
    CrossrefPubMedSearch in Google Scholar
  • 14 Kommission für Krankenhaushygiene und Infektionsprophylaxe: Anforderungen an die Hygiene bei Punktionen und Injektionen. Bundesgesundheitsbl 2011; 54: 1135-1144
    CrossrefPubMedSearch in Google Scholar
  • 15 Kommission für Krankenhaushygiene und Infektionsprophylaxe: Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten. Bundesgesundheitsbl 2012; 55: 1244-1310
    CrossrefPubMedSearch in Google Scholar
  • 16 Khan TS, Sharma E, Singh B. et al. Aspirin Increases the Risk of Nondiagnostic Yield of Fine-Needle Aspiration and Biopsy of Thyroid Nodules. Eur Thyroid J 2018; 7: 129-132
    CrossrefPubMedSearch in Google Scholar
  • 17 Patti G, Micieli G, Cimminiello C. et al. The Role of Clopidogrel in 2020: A Reappraisal. Cardiovasc Ther 2020; 16: 8703627
    CrossrefPubMedSearch in Google Scholar