Research & Academic Exchange

[Taipei Veterans General Hospital] [Academic Exchange] [Transarterial Microembolization (TAME)] 2023-05-03

Creator: Bow Wang, M.D.
Published: 2023-05-07

2023-05-07Author and reviewer: Bow Wang, M.D.

[Taipei Veterans General Hospital] [Academic Exchange] [Transarterial Microembolization (TAME)] 2023-05-03 — related image 1

Author: Bow Wang, M.D.

Thank you to Dr. Wu Ching-lan from Taipei Veterans General Hospital and the hospital for the invitation to give a lecture on musculoskeletal and related treatment experiences at National Cheng Kung University. I was also very happy to have further discussions and exchanges with many doctors from the Rehabilitation Department at Taipei Veterans General Hospital on related topics.

[Taipei Veterans General Hospital] [Academic Exchange] [Transarterial Microembolization (TAME)] 2023-05-03 — related image 2

The attentive listening and follow-up inquiries from the Radiology and Rehabilitation Departments at Taipei Veterans General Hospital were also gratifying, and it is hoped that this will provide more patients suffering from pain with another treatment option.

[Taipei Veterans General Hospital] [Academic Exchange] [Transarterial Microembolization (TAME)] 2023-05-03 — related image 3

Last week, I heard from the Pain Medicine Society about Bow Wang, M.D.-kai, Director of the Pain Management Department at Tzu Chi Hospital, introducing intraosseous regenerative injection for improving bone marrow edema and related theories. This aligns perfectly with the literature I've been collaborating with this year on Transarterial Microembolization (TAME) for improving pain caused by bone marrow edema. Therefore, I'd like to take this opportunity to share it with everyone at Taipei Veterans General Hospital.For those interestedPlease click here to view the literature。

[Taipei Veterans General Hospital] [Academic Exchange] [Transarterial Microembolization (TAME)] 2023-05-03 — related image 4

In knee osteoarthritis, the subchondral bone marrow edema contains disordered proliferation and malformed micro-arteries. Its presence causes damage and decomposition of nearby cartilage.

[Taipei Veterans General Hospital] [Academic Exchange] [Transarterial Microembolization (TAME)] 2023-05-03 — related image 5

Osteophils at the cartilage junction can also introduce chronic pain mediators, further leading to the formation of pain nerves and even central sensitization, thus expanding the local pain area.

[Taipei Veterans General Hospital] [Academic Exchange] [Transarterial Microembolization (TAME)] 2023-05-03 — related image 6

Therefore, Transarterial Microembolization (TAME), in addition to inhibiting pain nerves accompanied by disordered vascular supply by eliminating these disordered proliferations and malformed micro-arteries, also has the potential to inhibit and stop cartilage destruction and decomposition.

Besides knee osteoarthritis, the prognosis of Transarterial Microembolization (TAME) for different indications is listed below in Chinese translation for physicians who need to refer patients.

Indications and prognosis for treatment of various body parts using 【Transarterial Microembolization (TAME)】: (For patients who have not shown significant improvement after more than three months of traditional treatments, including medication and injections, and whose pain score exceeds 5/10)

【1. Most likely to improve after treatment】

Frozen 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 not definitively diagnosed), 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's metatarsalgia (significantly visualized at the affected area), postherpetic neuralgia (PHN), rib/intercostal pain.

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【4. Few people have experienced improvement with this method, so it is not highly recommended, but there is 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 related to herniated discs in the elderly.

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