Musculoskeletal Intervention Center, Okuno Clinic, Tokyo, Japan; Musculoskeletal Intervention Center, Edogawa Hospital, Tokyo, Japan.
Department of Interventional Radiology, Miyakojima IGRT Clinic, Osaka, Japan.
J Vasc Interv Radiol. 2022 Dec;33(12):1468-1475.e8. doi: 10.1016/j.jvir.2022.08.016. Epub 2022 Aug 19.
To assess the feasibility of transarterial embolization (TAE) for recalcitrant nighttime shoulder pain in a multicentric study.
This prospective, open-label, feasibility trial included 100 patients treated at 5 institutions. TAE was performed in 76 patients with adhesive capsulitis (AC) and 24 patients with symptomatic rotator cuff tears (sRCTs). The ipsilateral radial artery was punctured, and imipenem/cilastatin sodium was infused as an embolic agent. Adverse events, 10 point pain numerical rating scale (NRS), range of motion (ROM) of the shoulder joint, and quality of life (via the EuroQol-5D [EQ-5D]) were evaluated.
All patients exhibited neovascularity on baseline angiography, and all TAE procedures were performed successfully. No patient experienced a major adverse event. The mean nighttime pain NRS scores at baseline and 1, 3, and 6 months after TAE were 6.4 ± 2.2, 3.4 ± 2.6, 2.3 ± 2.5, and 1.6 ± 2.2, respectively (for all, P < .001). The mean ROM of anterior elevation at baseline and 1, 3, and 6 months after TAE were 97° ± 29°, 119° ± 28°, 135° ± 27°, and 151° ± 17°, respectively (for all, P < .001). The mean EQ-5D scores at baseline and 1, 3, and 6 months after TAE were 0.63 ± 0.17, 0.73 ± 0.16, 0.80 ± 0.17, and 0.84 ± 0.17, respectively (for all, P < .001). There was no significant difference in the clinical success rate between the AC and sRCT groups.
TAE for nighttime shoulder pain caused by AC and sRCTs was feasible with sufficient safety and efficacy.
在一项多中心研究中评估经动脉栓塞术（TAE）治疗顽固性夜间肩部疼痛的可行性。
本前瞻性、开放标签、可行性试验纳入了在 5 家机构接受治疗的 100 例患者。76 例粘连性肩关节囊炎（AC）患者和 24 例有症状肩袖撕裂（sRCT）患者接受 TAE 治疗。经同侧桡动脉穿刺，注入亚胺培南/西司他丁钠作为栓塞剂。评估不良事件、10 分疼痛数字评分量表（NRS）、肩关节活动范围（ROM）和生活质量（通过欧洲五维健康量表 [EQ-5D]）。
所有患者的基线血管造影均显示新生血管，所有 TAE 手术均成功完成。无患者发生重大不良事件。TAE 后 1、3、6 个月的夜间疼痛 NRS 评分分别为 6.4 ± 2.2、3.4 ± 2.6、2.3 ± 2.5 和 1.6 ± 2.2（均 P <.001）。TAE 后 1、3、6 个月的前举 ROM 分别为 97° ± 29°、119° ± 28°、135° ± 27°和 151° ± 17°（均 P <.001）。TAE 后 1、3、6 个月的 EQ-5D 评分分别为 0.63 ± 0.17、0.73 ± 0.16、0.80 ± 0.17 和 0.84 ± 0.17（均 P <.001）。AC 和 sRCT 组的临床成功率无显著差异。
对于 AC 和 sRCT 引起的夜间肩部疼痛，TAE 是一种可行的治疗方法，具有足够的安全性和疗效。
