Vascular and Interventional Radiology and the University Hospital of León, Calle Altos de Nava, SN 24080, León, Spain; Institute of Biomedicine (IBIOMED), University of León, León, Spain.
Radiology Department, Clínica Universidad de Navarra, Madrid, Spain.
J Vasc Interv Radiol. 2021 Apr;32(4):489-496. doi: 10.1016/j.jvir.2020.11.006. Epub 2021 Jan 19.
To assess the clinical outcomes of transcatheter arterial embolization (TAE) for secondary stiff shoulder (SSS).
This is a retrospective analysis of prospectively collected data performed between January 2017 and December 2019. This study comprised 25 patients (20 women and 5 men; median age, 49 years; range 27-59) with SSS resistant to conservative management during at least 3 months. The median time of stiffness was 12 months. The etiology of SSS was postoperative in 14 patients (56%) and posttraumatic in the remaining 11 patients (44%). Periods of immobilization in all patients were associated. TAE was performed, and technical aspects, adverse events, changes for pain, and physical examination before and 6 months after TAE were assessed.
Abnormal vessels were observed in 20 of 25 (80%) of the procedures. Transitory cutaneous erythema was noted in 4 patients treated after TAE. Significant differences were observed in the median pain visual analog scale reduction between before and 6 months after TAE (8 vs 2, P < .001). Shoulder mobility significantly improved in both flexion and abduction degrees between before and at 6 months after TAE in (70° vs 150°; P < .001). No symptoms of recurrence appeared.
TAE can result in pain reduction and mobility improvement in patients with SSS refractory to conservative therapy.
评估经导管动脉栓塞术(TAE)治疗继发性僵硬肩(SSS)的临床疗效。
这是一项回顾性分析,对 2017 年 1 月至 2019 年 12 月期间前瞻性收集的数据进行分析。本研究共纳入 25 例(20 名女性,5 名男性;中位年龄 49 岁;年龄范围 27-59 岁)对至少 3 个月的保守治疗无效的 SSS 患者。僵硬的中位时间为 12 个月。SSS 的病因在 14 例患者(56%)中为术后,在其余 11 例患者(44%)中为创伤后。所有患者均存在固定期。进行 TAE,评估技术方面、不良事件、疼痛变化以及 TAE 前后 6 个月的体格检查。
在 25 例(80%)患者中观察到异常血管。4 例 TAE 后治疗的患者出现短暂性皮肤红斑。TAE 前后疼痛视觉模拟评分中位数(8 分比 2 分,P<0.001)有显著差异。在 TAE 前后,肩关节活动度在屈曲和外展度上均有显著改善(70°比 150°;P<0.001)。无复发症状出现。
TAE 可减轻对保守治疗无效的 SSS 患者的疼痛,并改善其活动度。