[Adhesive Capsulitis/Fibrosis] [Transarterial Microembolization (TAME)] Successful Case Sharing

Author: Bow Wang, M.D.

Ms. P, 66 years old, was on long-term medication to control her rheumatic immune disease. She experienced pain in multiple joints, especially her shoulders, for over two years, scoring a maximum of 10 on the pain scale. She had difficulty raising her shoulders, making dressing and bathing difficult and sometimes requiring assistance. She also experienced severe nighttime pain that made it hard to sleep. After undergoing various injections, including proliferative therapy, at the Taichung Construction Bank Clinic, Dr. Chen Jianxing, her pain improved to a score of 5. She was then referred to the Tainan National Cheng Kung University Interventional Medical Center Clinic, where Bow Wang, M.D. provided further treatment.

After discussion, Bow Wang, M.D. was used on Ms. P. Guided by X-ray fluoroscopy and under local anesthesia, a microcatheter was inserted through the radial artery in the wrist to locate the painful area in the shoulder. Under arterial angiography, contrast agent was injected into Bow Wang, M.D. to identify excessive and disordered capillary-like vessels in the shoulder joint capsule; then, embolic medication was injected through the microcatheter to remove these abnormal capillary-like vessels.

Two weeks after treatment, Ms. P's nighttime throbbing pain, tenderness, and range of motion in her shoulder significantly improved or even disappeared.

However, Bow Wang, M.D. reminds you that the application of 【Transarterial Microembolization (TAME)】 in 【adhesive capsulitis/frozen shoulder】has its limitations. The main indication is a pain index exceeding 5 points, and patients who have not seen significant improvement after more than three months of various traditional treatments. Side effects include local hematoma and bruising at the puncture site; and temporary local discoloration at the embolization site, which will improve and disappear within minutes to a month. It is recommended that patients undergo a detailed evaluation by a physician to confirm the true source of pain and the diagnosis, and fully discuss the treatment process and related precautions with their doctor and family before receiving treatment for better assurance.

#Indications and prognosis of 【Transarterial Microembolization (TAME)】for treatment of various body parts:

(For patients who have not shown significant improvement after more than three months of various traditional treatments, including medication and injections, and whose pain score exceeds 5/10)

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【1. Most likely to improve after treatment】

Fifty shoulder, tennis elbow/golfer's elbow, lower back pain (confirmed by Enhanced MRI, with significant visualization of the facet joint or surrounding soft tissues), jumper's knee, mild degenerative osteoarthritis, Achilles tendinitis, plantar fasciitis.

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【2. Likely to improve after treatment】

Heberden's node (finger osteoarthritis), wrist osteoarthritis, sacroiliitis, severe osteoarthritis of the knee lower back pain (MRI: no clear diagnosis), severe enthesitis (poor response after 5 or more injections, significant Doppler vascularization and local thickening, high daily workload).

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【3. Approximately 50% chance of improvement】

Morton metatarsalgia (significantly visible on affected area), postherpetic neuralgia (PHN), rib/intercostal pain.

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【4. Few people experience improvement with this method, so it's not highly recommended, but there's still a chance of improvement.】

Severely deformed osteoarthritis of the hip, Morton metatarsalgia (no radiographic findings).

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【5. This method is not recommended.】

Intermittent claudication caused by spinal stenosis, Complex Regional Pain Syndrome (CRPS) lasting more than three years, and pain associated with herniated discs in the elderly.