Adhesive capsulitis embolization: a narrative review

Adhesive capsulitis is a painful shoulder disorder characterized by progressive stiffness and loss of range of motion, affecting approximately 2%-5% of the general population. Adhesive capsulitis embolization (ACE) is a minimally invasive endovascular technique that targets abnormal neovascularization associated with capsular inflammation. This narrative review summarizes the current literature on ACE for adhesive capsulitis, focusing on procedural technique and reported clinical outcomes. Eleven published clinical studies comprising 422 patients were identified and summarized descriptively. Across these studies, embolization was associated with improvement in pain, functional outcomes, and shoulder range of motion, with no major complications reported. However, definitions of technical success, clinical success, minimal clinically important difference (MCID), outcome measures, and follow-up duration varied between studies, limiting direct comparison. Although early short- to mid-term results are promising, the available evidence remains limited. Larger prospective studies with longer follow-up duration, standardized outcome reporting, stage stratification, and appropriate control groups are needed to define the true value of ACE in the management of adhesive capsulitis.