Effects of Transcatheter Arterial Embolization for Chronic Intractable Shoulder Pain: A Prospective Clinical Study

Objectives: Based on the idea that the neovessels and nerves are a possible cause of pain, transcatheter arterial embolization (TAE) has been reported as a novel adjunctive treatment with good outcomes. Purpose of this was to examine the short-term outcomes of TAE including 1-day follow-up results in patients with chronic shoulder pain using patient-reported outcome measures.

Study Design: Prospective study.

Methods: TAE was performed with a suspension of imipenem/cilastatin sodium in contrast agent. Subjects were assessed before, 1 day after, and 1 month after the procedure using the visual analogue scale (VAS, 0–10), shoulder pain and disability index (SPADI, 0–100), and Constant–Murley score (CMS, 0–100).

Results: A total of 10 patients were enrolled. All procedures were technically successful with the radial artery approach. Abnormal neovessels with angiographic blushes were identified in all cases, with a mean of 3.3 abnormal neovessels per patient (range, 2–4) and a total of 41 arteries embolized, averaging 4.1 vessels per patient (range, 3–5). Baseline VAS, SPADI, and CMS were 3.5, 50.0, and 47.4, respectively. The 1-day follow-up (VAS, 2.0; SPADI, 26.3; CMS, 68.1; p ≤ 0.001 compared to baseline) and 1-month follow-up (VAS, 1.7; SPADI, 24.3; CMS, 72.8; p ≤ 0.002 compared to baseline) demonstrated significant improvements. The 1-day and 1-month follow-up results were not significantly different.

Conclusions: Substantial pain relief and functional scales improvement were observed both immediately and 1 month after TAE in chronic intractable shoulder pain. TAE may be an effective alternative treatment for patients with shoulder pain who do not respond to conservative or surgical treatment.

Trial Registration: Korean Registry of Clinical Trials: KCT0004720