Superselective Transarterial Embolization Using Imipenem/Cilastatin Sodium for Plantar Fasciitis Refractory to...

To assess the feasibility, safety, and effectiveness of superselective transarterial embolization (TAE) using imipenem/cilastatin sodium for plantar fasciitis (PF) refractory to conservative management.

This retrospective study included 12 patients (50% men; mean age, 36 years [SD ± 9.07]) with PF (pain on palpation along the proximal plantar fascia and thickened plantar fascia [>4 mm] on magnetic resonance [MR] imaging) refractory to conservative management for ≥3 months. Superselective cannulation of branches from the posterior tibial artery (PTA), supplying the point of maximal pain at the plantar fascia origin, was performed, and branches showing hypervascular staining (contrast blush) were embolized using a suspension of 500 mg of imipenem/cilastatin sodium in 5 mL of iodinated contrast agent. Visual analog scale (VAS) was used to assess pain at baseline, 1 day, 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months after procedure.

PTA branches supplying area of hypervascular staining could be superselectively embolized in 11 of 12 patients (technical success, 91.7%; mean number of arteries embolized, 1.5 [SD ± 0.7]; mean amount of embolizing agent used, 1.1 mL [SD ± 0.5]). A significant decrease in VAS score was noted on day 1 after procedure (2.27 [SD ±1.19] vs 7.36 [SD ± 0.92]; P < .0001), which persisted through 12 months of follow-up. Clinical success, defined as ≥50% reduction in VAS score at 6 months, was achieved in 8 of 11 (72.73%) patients who underwent embolization and was sustained through 12 months of follow-up.

Superselective TAE using imipenem/cilastatin sodium is feasible, safe, and effective in alleviating pain associated with PF refractory to conservative management, with a low risk of adverse events.