TAME & Musculoskeletal Embolization
[Triangular Fibrocartilage Complex Injury] [Transarterial Microembolization (TAME)] Successful Case Sharing
![[Triangular Fibrocartilage Complex Injury] [Transarterial Microembolization (TAME)] Successful Case Sharing — related image 1](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjyiz9MMt7vtmE65jLT33jcjtaL-x5XVHFtJSFn2PoXPm-PK89LWChYyjAH7cF9K_x5QP7FHaSQn8EqtbIDok-hbO100ht5CPDyVVSTx1re4afGCx90Ok82qQ-fX79w7tQQgYZNJ8OyYGsr0V-2ro-oV48lMO9IInjpmw6S7_940Vx8wrJBxepcA7-Ln6hg/s1076/TFCC%20injury.jpg)
Author: Bow Wang, M.D.
Mr. T, 21 years old, has been experiencing persistent pain on the ulnar side of his wrist since a car accident a year ago, which has limited his mobility, especially when playing wind instruments. His pain score is 6 out of 10.
Despite prolonged rehabilitation and injection treatments, Mr. T has not shown significant improvement. After a clinical physical examination by Dr. Yang Daihua of the Department of Orthopedics at National Cheng Kung University Hospital and diagnosis using the magnetic resonance imaging (MRI), Mr. T was diagnosed with a triangular fibrocartilage complex (TFCC) injury. He was subsequently referred to Bow Wang, M.D. at the Interventional Medical Center of National Cheng Kung University Hospital in Tainan for further treatment.
Following discussion, the Transarterial Microembolization (TAME) was used on Mr. T. Under X-ray fluoroscopy guidance, local anesthesia, and arterial angiography, the Bow Wang, M.D. was injected with contrast agent to identify excessively proliferating and disordered capillary-like vessels in the triangular fibrocartilage complex. Embolizing medication was then injected through a microcatheter to remove these abnormal capillary-like vessels.
Two weeks after treatment, Mr. T's pain score on the ulnar side of his wrist, including when playing wind instruments, dropped significantly from 6 to 1. His range of motion also improved significantly, resulting in a marked increase in his quality of life.
The triangular fibrocartilage complex (TFCC) is a complex structure located between the ulnar side (little finger side) of the wrist joint and the carpal bones. It is composed of a group of ligaments and fibrocartilage, often described as a semi-lunar version of the wrist joint. The TFCC is responsible for maintaining the stability of the distal radioulnar joint and the ulnar side (near the little finger) of the carpal bones, as well as bearing and transmitting pressure from the hand.
Once the TFCC is injured, wrist stability decreases, and pain begins to appear, becoming the most common cause of ulnar wrist pain. TFCC injuries are usually caused by repetitive or traumatic wrist sprains, weight-bearing swings, or prolonged repetitive movements. Treatment methods for TFCC injuries include rest, physical therapy, bandaging and bracing, and surgery.
Recent literature shows that chronic inflammation results in the proliferation of disordered capillary-like microarteries and accompanying pain nerves. 【Transarterial Microembolization (TAME)】 works by embolizing and clearing these disordered, proliferating capillary-like micro-arteries to achieve anti-inflammatory, swelling-reducing, and analgesic effects. However, Bow Wang, M.D. reminds you that 【Transarterial Microembolization (TAME)】treatment also has its limitations. Its 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.
This treatment is not suitable in the following situations:
1. Severe tendon or ligament damage or rupture
2. Poor kidney function (eGFR < 30 mL/min/1.73m2)
3. Low platelet count, abnormal coagulation function
4. The patient is unable to lie flat for two hours.
5. Pregnancy
Side effects of treatment include local hematoma and bruising at the puncture site; temporary local discoloration at the embolization site, which will improve and disappear within minutes to one month.
It is recommended that patients undergo a detailed evaluation by a physician to confirm the true source of pain. After thorough discussion with the physician and family to understand the treatment process and related precautions, treatment is more effective.
This page is for medical education and academic communication. It does not replace individual diagnosis or treatment advice.
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