*3.3. Percutaneous Procedures*

Percutaneous procedures play an important role in the management of oligometastatic BMs from DTC. They are less invasive alternatives to surgery, especially in patients with decreased PS that is not suitable for surgery or with local tumor recurrence at the previously operated site. They can be applied in combination with systemic therapy in cases of symptomatic BM at a higher risk of local complications. The available percutaneous techniques for BMs from DTC are categorized into ablative, vascular, and consolidative treatment, which can be applied alone or combined and tailored according to the specific

needs of the patient [69]. Cazzato et al. published their experience with percutaneous procedures including cementoplasty (77.5%) and ablation techniques (22.5%) for BMs from DTC. They reported a complete local remission rate of 56% at a median follow-up after treatment of 4.6 years, and an OS rate after treatment of 72%, 67%, and 60% at 1, 2, and 3 years, respectively [70]. However, well-designed studies of these techniques are scarce; most are retrospective, reliant on small sample sizes, and often conducted without a long-term follow-up. Future studies that compare the efficacy and tolerability of different procedures are required.
