Department of Radiology, Taichung Veterans General Hospital, No.1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan, 40705, Republic of China.
Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, 402, Taiwan.
Eur Radiol. 2024 May;34(5):3260-3270. doi: 10.1007/s00330-023-10328-5. Epub 2023 Oct 19.
Transarterial microembolization (TAME) is an increasingly well-known novel and minimally invasive treatment option for painful chronic musculoskeletal diseases that is gaining popularity. Although the safety and effectiveness of TAME have been established, limited knowledge of intraarticular and musculocutaneous arterial anatomy may lead to challenges and complications. This article aims to present cases illustrating these challenges and complications, based on multicenter experiences and a comprehensive literature review. Furthermore, the article also provides preventive tips, solutions, and follow-up strategies to reduce the learning curve for interventional radiologists and facilitate familiarity with post-TAME follow-up images for diagnostic radiologists. CLINICAL RELEVANCE STATEMENT: This article illustrates the intra- and post-interventional complications of transarterial microembolization (TAME) through detailed pictorial reviews, including how to distinguish them from normal angiographic findings. It provides strategies for their prevention, management, and follow-up, which can further improve clinical outcomes. KEY POINTS: • Transarterial microembolization for chronic musculoskeletal pain may result in intrainterventional challenges (IIC) and postinterventional complications (PIC), and their importance may be underestimated. • The intrainterventional challenges include microarterial perforation, arterial dissection, and catheter tip fracture, whereas postinterventional complications include tissue ischemia-related complications, puncture site hemorrhage, and arterial injury. • Being familiar with the intrainterventional challenges and postinterventional complications may help minimize the procedure risk and improve outcomes.
经动脉微栓塞（TAME）是一种日益知名的新型微创治疗选择，用于治疗慢性肌肉骨骼疼痛疾病，越来越受到关注。尽管 TAME 的安全性和有效性已经得到证实，但对关节内和肌肉皮动脉解剖结构的了解有限，可能会导致挑战和并发症。本文旨在基于多中心经验和全面的文献复习，通过病例展示来介绍这些挑战和并发症。此外，文章还提供了预防技巧、解决方案和随访策略，以减少介入放射科医生的学习曲线，并促进诊断放射科医生对 TAME 后随访图像的熟悉程度。临床相关性声明：本文通过详细的影像学回顾，展示了经动脉微栓塞（TAME）的介入内和介入后并发症，包括如何将它们与正常血管造影发现区分开来。它提供了针对这些并发症的预防、管理和随访策略，这可以进一步改善临床结果。关键点：• 慢性肌肉骨骼疼痛的经动脉微栓塞可能会导致介入内挑战（IIC）和介入后并发症（PIC），并且它们的重要性可能被低估。• 介入内挑战包括微动脉穿孔、动脉夹层和导管尖端断裂，而介入后并发症包括与组织缺血相关的并发症、穿刺部位出血和动脉损伤。• 熟悉介入内挑战和介入后并发症有助于最大限度地降低手术风险并改善结果。
