[Transarterial microembolization in tendinopathies : Overview and current state of research].

Abstract

Background: Chronic tendinopathies are common causes of persistent musculoskeletal pain. In refractory cases, pathological hypervascularization and neo-innervation play a key role in pain generation. Transarterial microembolization (TAME) aims to reduce this abnormal vascularity using a minimally invasive approach.

Purpose: This review summarizes current evidence regarding the efficacy and safety of TAME in selected tendinopathies.

Materials and methods: A narrative review of recent literature on TAME for adhesive capsulitis, medial and lateral epicondylitis, Achilles tendinopathy, and plantar fasciitis was conducted, focusing on technical aspects, embolic agents, and clinical outcomes.

Results: Available studies consistently demonstrate significant pain reduction and functional improvement following TAME across all indications. The strongest evidence exists for adhesive capsulitis and Achilles tendinopathy, with reported clinical success rates of approximately 80-90%. Procedures are typically performed catheter-guided using a superselective approach and temporary embolic agents, most commonly imipenem/cilastatin. No major complications have been reported.

Conclusion: TAME represents a safe and effective minimally invasive treatment option for selected refractory tendinopathies and may bridge the gap between conservative management and surgery. Further randomized controlled trials are required to define long-term outcomes and optimal patient selection.