Transcatheter arterial microembolization (TAME) in foot and ankle pathologies: current indications and future perspectives.

Abstract

Transcatheter arterial microembolization (TAME) is a minimally invasive endovascular procedure initially developed for bleeding control and later applied to the treatment of chronic musculoskeletal conditions characterized by pathological hypervascularization, to inhibit or reduce the release of inflammatory mediators. First introduced in anatomical districts such as the knee, TAME has more recently been proposed as a therapeutic option for chronic inflammatory foot and ankle disorders refractory to conservative treatment. A narrative review of the literature was conducted by searching PubMed using the keywords "microembolization," "transcatheter arterial microembolization," "TAME," "foot," and "ankle." The most recent and relevant studies, including case reports, case series, and retrospective studies, were analyzed, along with the reference lists of selected articles. Clinical indications, procedural techniques, embolic materials, clinical outcomes, and complications were evaluated. The main indications for TAME in foot and ankle pathology were Achilles tendinopathy, plantar fasciopathy, and, in a single reported case, non-union of a fifth metatarsal fracture. The procedure was predominantly performed using temporary embolic agents, most commonly imipenem/cilastatin sodium. All studies reported a technical success rate of 100%, with significant pain reduction and functional improvement in most patients. Reported complications were minor and transient, with no major adverse events documented.TAME represents a promising minimally invasive therapeutic option for chronic inflammatory foot and ankle conditions refractory to conservative management, particularly Achilles tendinopathy and plantar fasciopathy. Although preliminary clinical results are encouraging, the current evidence is limited by small sample sizes and low methodological quality, underscoring the need for larger, well-designed prospective studies.