Midterm Clinical Outcomes After Transcatheter Arterial Embolization for Lateral Epicondylitis Resistance to Conservative Treatment

Society of Interventional Radiology

Authors

Y Okuno, M Shibuya, Okuno Clinic, Tokyo, Japan

Purpose

To describe the safety and efficacy of transcatheter arterial embolization (TAE) for lateral epicondylitis that was resistant to conservative treatment.

Materials

This prospective study was conducted in 52 patients with lateral epicondylitis that was resistant to conservative treatments for more than 3 months, with a symptom duration longer than 6 months, and with moderate to severe pain who were treated with TAE between March 2013 and October 2017. The institutional review board approved the present study. All procedures were performed in the outpatient clinic under local anesthesia. Imipenem/cilastatin sodium was used as an embolic material. Four patients were lost to follow-up and the remaining 48 patients were followed for up to 4 years after TAE.

Results

Abnormal vessels were identified in all of the patients. No major adverse events were observed. The Quick Disability of the Arm, Shoulder and Hand scores significantly decreased from baseline at 1, 3, 6, and 24 months post-treatment (52.1 vs. 21.4, 8.2, 5.6, and 3.7 respectively; all P < 0.001). There was a statistically significant (P < 0.001) change from baseline to the last observed value in all of the clinical parameters, including the numerous pain rating scale scores, Patient-Rated Tennis Elbow Evaluation scores, and pain-free grip strength. Magnetic resonance images that were obtained 2 years after TAE in 32 patients showed an improvement in tendinosis and tear scores compared to baseline, and no patients showed bone marrow necrosis, obvious cartilage loss, or muscle atrophy.

Conclusions

TAE could be one possible treatment option for lateral epicondylitis patients who fail to improve with conservative treatments.

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