Comparative Safety of 3 Temporary Embolic Agents in Transcatheter Arterial Embolization for Degenerative,...

To evaluate the safety and degree of pain relief of 3 rapidly biodegraded embolic materials, including imipenem (IPM)/cilastatin sodium (CS), quick-soluble gelatin sponge particles (QS-GSPs), and resorbable microsphere (RMs), in transcatheter arterial embolization (TAE) for degenerative, inflammatory, and overuse joint disorders.

Consecutive 431 patients, 527 joints with refractory overuse injuries, knee osteoarthritis, frozen shoulder, symptomatic rotator cuff tear, synovitis of the foot joints, and persistent pain after knee joint arthroplasty who underwent TAE between March 2020 and May 2023 were included in this retrospective study. IPM/CS, QS-GSPs, and RMs were used in 140 patients (176 TAEs), 136 patients (163 TAEs), and 155 patients (182 TAEs), respectively. Adverse events were monitored immediately after the procedure. Changes in pain numeric rating scale (NRS) score were evaluated at 1, 3, and 6 months after TAE.

No severe adverse events were observed. Increased pain at the site of embolization after the procedure lasting more than 7 days occurred in 7.1%, 22.1%, and 5.8% of patients with IPM/CS, QS-GSPs, and RMs, respectively, more commonly in the elbow joint. The NRS score improved from the baseline to 1, 3, and 6 months with IPM/CS (6.9 [SD ± 1.3] vs 4.4 [SD ± 2.2], 3.6 [SD ± 2.3], and 3.1 [SD ± 2.4], respectively; all P < .0001), QS-GSPs (6.4 [SD ± 1.5] vs 4.3 [SD ± 2.1], 3.6 [SD ± 2.2], and 3.0 [SD ± 2.1], respectively; all P < .0001), and RMs (7.0 [SD ± 1.3] vs 4.4 [SD ± 2.2], 3.2 [SD ± 2.1], and 2.3 [SD ± 1.8], respectively; all P < .0001).

IPM/CS, QS-GSPs, and RMs demonstrated acceptable safety profiles and effectively alleviated pain in TAE for degenerative, inflammatory, and overuse joint disorders.