Park Juil, Lee Sang Hwan, Seo Beom-Seok, Kim Dong Hyun, So Young Ho, Kim Minuk, Lee Jae Hwan, Kim Hyo-Cheol, Cho Soo Buem, Kim Young Jae, Choi Woosun
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology, H Plus Yangji Hospital, Seoul, Republic of Korea.
J Vasc Interv Radiol. 2023 Jan;34(1):63-70.e1. doi: 10.1016/j.jvir.2022.10.003. Epub 2022 Oct 7.
To evaluate the effectiveness and safety of transarterial embolization (TAE) for chronic Achilles tendinopathy (AT) refractory to conservative treatment.
This retrospective study included 20 patients (12 men and 8 women; mean age, 30.3 years) who received TAE using imipenem/cilastatin sodium for refractory chronic AT from May 2019 to April 2021. Nine patients had bilateral involvement. A total of 29 procedures were performed (8 for nonathletes and 21 for athletes). If feasible, embolization was performed superselectively of the arterial branch demonstrating hypervascularity, early venous drainage, and/or supplying the pain site noted using a radiopaque marker. The visual analog scale (VAS, 0-10) score was used to assess pain symptoms at baseline and during the follow-up period (1 day; 1 week; 1, 3, and 6 months; and open period). Clinical success was defined as a decrease of >50% in the VAS score at 6 months when compared with baseline.
In 25 (86.2%) of 29 procedures, clinical success was achieved. Significant decreases in the VAS scores were noted at 1 day, 1 week, 1 month, 3 months, and 6 months (6.86 at the baseline vs 3.48, 3.41, 3.10, 2.55, and 1.62, respectively; all P < .01). For patients available for the 12- and 24-month follow-ups (n = 19 and 6, respectively), the mean VAS scores significantly decreased (6.84 vs 2.00 and 7.33 vs 1.17, respectively; all P < .01). No serious adverse events were observed during follow-up.
TAE may alleviate pain for patients with chronic AT refractory to the conservative treatment with a low risk of adverse events.
评估经动脉栓塞术（TAE）治疗保守治疗无效的慢性跟腱病（AT）的有效性和安全性。
本回顾性研究纳入了20例患者（12例男性和8例女性；平均年龄30.3岁），这些患者在2019年5月至2021年4月期间因难治性慢性AT接受了亚胺培南/西司他丁钠TAE治疗。9例患者为双侧受累。共进行了29次手术（8例非运动员，21例运动员）。如果可行，对显示血管增多、早期静脉引流和/或供应使用不透射线标记物标记的疼痛部位的动脉分支进行超选择性栓塞。采用视觉模拟量表（VAS，0-10）评分在基线和随访期间（1天、1周、1、3和6个月以及开放期）评估疼痛症状。临床成功定义为与基线相比6个月时VAS评分降低>50%。
29次手术中有25次（86.2%）取得了临床成功。在1天、1周、1个月、3个月和6个月时VAS评分显著降低（基线时为6.86，分别降至3.48、3.41、3.10、2.55和1.62；所有P <.01）。对于可进行12个月和24个月随访的患者（分别为n = 19和6），平均VAS评分显著降低（分别为6.84对2.00和7.33对1.17；所有P <.01）。随访期间未观察到严重不良事件。
TAE可能减轻保守治疗无效的慢性AT患者的疼痛，且不良事件风险较低。
