Lee Jae Hwan, Cho Soo Buem, Kim Kun Young, Lee Chong-Ho, Yoon Chang Jin, Kim Minuk, So Young Ho, Lee Sang Hwan, Hur Saebeom
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Cardiovasc Intervent Radiol. 2025 Aug;48(8):1200-1204. doi: 10.1007/s00270-025-04120-9. Epub 2025 Jul 14.
To evaluate the feasibility and safety of combined percutaneous sclerotherapy plus transarterial embolization for refractory sports-related tendinopathy in young athletes.
Twelve athletes with 20 lesions (13 Achilles tendinopathies, 6 patellar tendinopathies, 1 iliotibial band syndrome), suffering pain persisting >3 months despite conservative management were included. Ultrasound-guided foam sclerosant was injected into the peri-tendinous subcutaneous tissue at the most painful area until approximately 50% pain relief was achieved. Immediately after the sclerotherapy, angiography was performed, and hypervascular neovessels at the pain site were embolized with a mixture of iondinated contrast medium and Imipenem/Cilastatin. Visual analog scale (VAS) scores were measured and peri- and post-procedural adverse events were recorded.
Sclerosant injection produced an immediate ~50% pain reduction in all treated lesions, after which TAME was performed in 19 of 20 lesions (95%). Angiographic hypervascular staining was observed in 95% (19/20) of cases, facilitating targeted embolization. The mean sclerosant volume and imipenem amount were 1.4 ± 0.7 mL and 370.1 ± 14.9 mg, respectively. Mean VAS scores decreased from 6.7 ± 1.2 at baseline to 3.2 ± 1.1 at 1 week and 2.7 ± 0.8 at 6 months (p < 0.01). Clinical success was achieved in 18 of 20 lesions (90%), corresponding to 10 of 12 patients (83%). Minor complications occurred in 2 cases (2 groin hematomas), and all patients experienced mild post-injection soreness resolving within 4 days. No major complications or serious adverse events were observed.
The combined sclerotherapy plus embolization technique is feasible and safe for treating refractory lower-extremity tendinopathies in young athletes. Comparative studies are needed to assess potential added benefits.
评估经皮硬化疗法联合经动脉栓塞术治疗年轻运动员难治性运动相关肌腱病的可行性和安全性。
纳入12名运动员，共20处损伤（13例跟腱病、6例髌腱病、1例髂胫束综合征），尽管接受了保守治疗，但疼痛仍持续超过3个月。在最疼痛区域的肌腱周围皮下组织内超声引导注射泡沫硬化剂，直至疼痛缓解约50%。硬化疗法后立即进行血管造影，并用碘化造影剂和亚胺培南/西司他丁混合物栓塞疼痛部位的高血管新生血管。测量视觉模拟量表（VAS）评分，并记录围手术期和术后不良事件。
硬化剂注射使所有治疗损伤的疼痛立即减轻约50%，之后20处损伤中的19处（95%）进行了经动脉栓塞术联合硬化疗法（TAME）。95%（19/20）的病例观察到血管造影高血管染色，便于进行靶向栓塞。硬化剂平均用量和亚胺培南用量分别为1.4±0.7mL和370.1±14.9mg。VAS平均评分从基线时的6.7±1.2降至1周时的3.2±1.1和6个月时的2.7±0.8（p<0.01）。20处损伤中的18处（90%）获得临床成功，对应12例患者中的10例（83%）。2例出现轻微并发症（2例腹股沟血肿），所有患者均经历注射后轻度酸痛，4天内缓解。未观察到重大并发症或严重不良事件。
硬化疗法联合栓塞技术治疗年轻运动员难治性下肢肌腱病可行且安全。需要进行比较研究以评估潜在的额外益处。
