Barts Health NHS Trust, London, UK.
Queen Mary University of London, London, UK.
J Med Imaging Radiat Oncol. 2023 Oct;67(7):756-768. doi: 10.1111/1754-9485.13590. Epub 2023 Oct 9.
Angiogenesis and accompanying nerve fibres might cause unsettling joint pain. Studies have suggested that transcatheter arterial embolisation (TAE) of these abnormal neovessels could relieve pain and symptoms in patients with upper limb joint pain refractory to conventional treatment. This study aims to investigate the efficacy and safety of TAE in treating chronic pain of shoulder and elbow joints that have been resistant to other treatments. Using six databases, a systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The primary outcome involved changes in the visual analogue scale (VAS) after TAE; while secondary outcomes involved comparing other parameters where relevant. Average VAS decreased from baseline, then at 1 day, 1 week, 1 month, 3 months, 4 months, 6 months, 1 year, 2 years and 44 months (7.5 at baseline vs. 4.7, 4.3, 3.4, 2.1, 2.5, 1.2, 0.7, 1.1 and 0.1, respectively). Average Quick-DASH scores decreased from baseline, then at 1, 3 and 6 months (61.3 at baseline vs. 30.6, 19.3 and 6.9, respectively). Minor adverse events were reported in 27/143 (18.9%) patients, where they resolved spontaneously or with oral analgesia. TAE is a possible treatment option for refractory shoulder and elbow joint pain; however, randomised controlled trials are still required.
血管生成和伴随的神经纤维可能导致关节不适。研究表明，经导管动脉栓塞术（TAE）治疗这些异常新生血管可能缓解对常规治疗有抵抗的上肢关节疼痛的患者的疼痛和症状。本研究旨在探讨 TAE 治疗对其他治疗有抵抗的慢性肩肘关节疼痛的疗效和安全性。本研究采用 6 个数据库，按照系统评价和荟萃分析报告的首选条目（PRISMA）指南进行系统评价。主要结局是 TAE 后视觉模拟评分（VAS）的变化；次要结局是比较相关的其他参数。VAS 平均值从基线开始下降，然后在 TAE 后 1 天、1 周、1 个月、3 个月、4 个月、6 个月、1 年、2 年和 44 个月（基线时为 7.5，分别为 4.7、4.3、3.4、2.1、2.5、1.2、0.7、1.1 和 0.1）。Quick-DASH 平均评分从基线开始下降，然后在 TAE 后 1、3 和 6 个月（基线时为 61.3，分别为 30.6、19.3 和 6.9）。27/143（18.9%）名患者报告了轻微的不良反应，这些不良反应自发消退或用口服镇痛药缓解。TAE 可能是治疗难治性肩肘关节疼痛的一种选择；但是，仍需要随机对照试验。
