Okuno Yuji, Iwamoto Wataru, Matsumura Noboru, Oguro Sota, Yasumoto Taku, Kaneko Takao, Ikegami Hiroyasu
Musculoskeletal Intervention Center and Department of Sports Medicine, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa-ku, Tokyo 133-0052, Japan.
Musculoskeletal Intervention Center and Department of Sports Medicine, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa-ku, Tokyo 133-0052, Japan.
J Vasc Interv Radiol. 2017 Feb;28(2):161-167.e1. doi: 10.1016/j.jvir.2016.09.028. Epub 2016 Dec 19.
To evaluate clinical outcomes of transcatheter arterial embolization (TAE) for adhesive capsulitis resistant to conservative treatments.
This study comprised 25 patients (18 women and 7 men; mean age, 53.8 y; range, 39-68 y) with adhesive capsulitis resistant to conservative treatments. TAE was performed, and adverse events (AEs), pain visual analog scale (VAS) score changes, range of motion (ROM), and American Shoulder and Elbow Surgeons (ASES) scores were assessed.
Abnormal vessels were identified in all patients. No major AEs were associated with TAE. One patient was lost to follow-up. The remaining 24 patients were available for final follow-up (mean, 36.1 months; range, 30-44 months). Of the 24 patients, 16 (67%) experienced quick improvement of nighttime pain (ie, VAS scores decreased > 50% from baseline) within 1 week, and 21 (87%) improved within 1 month. In terms of mean overall pain (ie, pain at its worst), VAS scores significantly decreased at 1, 3, and 6 months after treatment (82 mm before treatment vs 52, 19, and 8 mm after treatment; P < .001). ASES scores significantly improved at 1, 3, and 6 months after treatment (16.1 before treatment vs 41.4, 69.1, and 83.5 after treatment; P < .001). No symptom recurrence or late-onset AEs were observed. Shoulder ROM and function further improved during midterm follow-up.
TAE is a possible treatment option for patients with adhesive capsulitis that has failed to improve with conservative treatments.
评估经导管动脉栓塞术（TAE）治疗对保守治疗耐药的粘连性囊炎的临床疗效。
本研究纳入了25例对保守治疗耐药的粘连性囊炎患者（18例女性，7例男性；平均年龄53.8岁；范围39 - 68岁）。实施TAE，并评估不良事件（AE）、疼痛视觉模拟量表（VAS）评分变化、活动范围（ROM）及美国肩肘外科医师（ASES）评分。
所有患者均发现异常血管。未发现与TAE相关的严重不良事件。1例患者失访。其余24例患者完成最终随访（平均36.1个月；范围30 - 44个月）。24例患者中，16例（67%）在1周内夜间疼痛迅速改善（即VAS评分较基线下降>50%），21例（87%）在1个月内改善。就平均总体疼痛（即最严重时的疼痛）而言，治疗后1、3和6个月VAS评分显著降低（治疗前82 mm，治疗后分别为52、19和8 mm；P <.001）。治疗后1、3和6个月ASES评分显著改善（治疗前16.1，治疗后分别为41.4、69.1和83.5；P <.001）。未观察到症状复发或迟发性不良事件。中期随访期间，肩部ROM和功能进一步改善。
对于保守治疗未能改善的粘连性囊炎患者，TAE是一种可行的治疗选择。
