Transcatheter arterial tendinopathy embolization as a treatment for painful and refractory tendinopathy: a systematic review and meta-analysis

Yan Epelboym; Colette Glaser; Zhou Lan; Jacob C Mandell; Ezra Burch; Timothy Killoran; Ali Guermazi

doi:10.1007/s00256-024-04649-9

Transcatheter arterial tendinopathy embolization as a treatment for painful and refractory tendinopathy: a systematic review and meta-analysis

Skeletal Radiol. 2024 Mar 27. doi: 10.1007/s00256-024-04649-9. Online ahead of print.

Authors

Yan Epelboym¹, Colette Glaser², Zhou Lan³, Jacob C Mandell⁴, Ezra Burch², Timothy Killoran², Ali Guermazi⁵

Affiliations

¹ Division of Angiography and Interventional Radiology, Department of Radiology, Brigham and Women's Hospital, Boston, MA, 02115, USA. yepelboym@bwh.harvard.edu.
² Division of Angiography and Interventional Radiology, Department of Radiology, Brigham and Women's Hospital, Boston, MA, 02115, USA.
³ Center for Clinical Investigation, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
⁴ Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁵ Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA, 02118, USA.

PMID: 38536416
DOI: 10.1007/s00256-024-04649-9

Abstract

Objective: Transcatheter arterial embolization (TAE) is a novel minimally invasive therapy for painful tendinopathy in patients with pain refractory to conservative management. The purpose of this study was to evaluate evidence on the efficacy of TAE for tendinopathy related pain.

Materials and methods: Using Embase, PubMed, and Web of Science, a systematic review and meta-analysis was performed to identify studies evaluating TAE for painful tendinopathy. The primary outcome measure was change in pain scale score at 6 months. A Ratio of Means (ROM) was used to compare the effect size post treatment as compared to baseline. The Visual Analog Scale (VAS) was used as the metric for comparison.

Results: After screening titles, abstracts, and the full text, 5 studies met inclusion criteria. A total of 97 tendinopathy embolization procedures performed in 74 patients were included. Patients who underwent TAE demonstrated declines in VAS ROM at 1 day 0.53 [95% CI 0.31,0.88], 1 week (0.51 [95% CI 0.32,0.79]), 1 month (0.45 [95% CI 0.29, 0.71]), 3-4 months (0.33 [95% CI 0.22,0.48]), and 6 months following embolization (0.18[95% CI 0.13,0.26]), respectively.

Discussion: TAE provides substantial short-term reductions in pain scores for patients suffering with refractory tendinopathy related pain of the rotator cuff, elbow extensor and flexor, Achilles, and patellar tendons.

Keywords: Embolization; Musculoskeletal Embolization; Tendinopathy.