TAME & Musculoskeletal Embolization

[Osteoarthritis of the Finger] [Arterial Perfusion Microvascular Removal] [Transarterial Microembolization (TAME)] Successful Case Sharing

Creator: Bow Wang, M.D.
Published: 2023-06-17

2023-06-17Author and reviewer: Bow Wang, M.D.

Author: Bow Wang, M.D.

Osteoarthritis of the Hand, [… **Arterial Perfusion Microvascular Debridement**

Ms. C, 69, is a housewife who has suffered from distal interphalangeal joint pain and deformities in both hands for several years. Some fingers even experience pain levels as high as 10 out of 10, requiring her to constantly endure this swelling and pain, which has also reduced her finger dexterity. Ms. C visited the National Cheng Kung University Hospital Interventional Medical Center for further discussion.

After consultation, Bow Wang, M.D. performed X-rays and blood tests on Ms. C, diagnosing her with **Osteoarthritis of the Fingers**. Following discussion, the center performed […]. [Arterial Perfusion Microvascular Debridement]

[Osteoarthritis of the Finger] [Arterial Perfusion Microvascular Removal] [Transarterial Microembolization (TAME)] Successful Case Sharing — related image 1

Guided by ultrasound and X-ray fluoroscopy, under local anesthesia, a microcatheter was inserted into the painful area via hand artery puncture. Under arterial angiography, embolizing medication was then injected through the microcatheter.

After treatment, Ms. L's pain was significantly reduced. After improvement, quality of life significantly improved. The pain score for the finger that was out of 10 dropped to 1, and for other fingers it even dropped to 0, eliminating the constant pain day and night.

Osteoarthritis of the fingers is common in women over 50 years old due to decreased female hormones, a lack of factors protecting joints, and long-term repetitive finger exertion. Occupations such as hairdressing, teaching, and housewifery are also high-risk groups.

【 [Arterial Infusion Microvascular Debridement] This treatment involves arterial injection to embolize and block abnormal new microvessels and related pain nerve innervations caused by osteoarthritis of the fingers, thereby improving finger pain caused by chronic joint inflammation.

Dr. Liang Gengwei of Taichung Chung Shan Hospital has extensive research experience in this technique and recently published his research in an international journal. Those interested can consult him. Bow Wang, M.D. is also pleased to be listed as an author. Dr. Wang and Dr. Liang are currently conducting other collaborative research, and we look forward to successful publication in the future.

However, Bow Wang, M.D. reminds that arterial embolization therapy for "osteoarthritis of the fingers" has limitations. The main indications are a pain index exceeding 5 points and no significant improvement after more than three months of various treatments.

In addition, differential diagnosis with rheumatoid arthritis is necessary. Rheumatoid arthritis is characterized by stiffness in the joints, especially upon waking in the morning, lasting for more than an hour; osteoarthritis usually develops slowly but is particularly painful in cold, damp weather or when moving the joints. Rheumatoid arthritis can affect joints throughout the body, typically affecting the wrist joints; while osteoarthritis usually develops slowly, most commonly causing swelling in the finger joints, especially the distal interphalangeal joints. Besides clinical symptoms, X-rays and blood tests for rheumatoid factor can aid in diagnosis.

This treatment is not suitable in the following situations:

1. Severe tendon or ligament damage or rupture

2. Pain accompanied by other nerve compression symptoms

3. Poor kidney function (eGFR < 30 mL/min/1.73m2)

4. Low platelet count, abnormal coagulation function

5. Patient unable to lie flat for two hours

6. Pregnancy

Treatment side effects include possible local hematoma and bruising at the puncture site; 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 fully discuss the treatment process and related precautions with their doctor and family before receiving treatment for better assurance.

Bow Wang, M.D. Clinic Online Appointment

This page is for medical education and academic communication. It does not replace individual diagnosis or treatment advice.

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