Prospective Analysis of Transarterial Embolization in Treating Hand Osteoarthritis

The first carpometacarpal (CMC) joint of the hand is among the most commonly affected sites of osteoarthritis (OA). Treatment options for CMC OA have remained largely unchanged over the years. This therapeutic, prospective cohort study aims to establish the significance of transarterial embolization (TAE) to treat persistent hand pain caused by CMC OA.

Fourteen patients presented with a history of persistent pain from the CMC joints. Eaton classification system was used to determine the severity of OA. Embolic agents were delivered through a microcatheter into the radial artery by a board-certified endovascular specialist. Clinical success was determined using a Wilcoxon signed-rank test to determine statistical significance in visual analog scale (VAS) scores reported by patients. Procedural success was determined by abolition of arterial blush following embolization. After the procedure, patients returned to the clinic for 1- and 6-month follow-up appointments.

Among 14 patients, average VAS scores at preliminary and follow-up appointments were 8.0, 3.1, and 2.6. A Wilcoxon signed-rank test showed statistical significance in observed improvement at both treatment checkpoints. Overall, 79% of patients experienced at least a 50% improvement in VAS scores by the end of the study period.

Transarterial embolization significantly improved pain among this patient cohort both at 1-month and 6-month postembolization appointments, with no major adverse outcomes reported. The findings within this study pose TAE as a safe, minimally invasive treatment for OA-induced hand pain across an extended time period when conservative measures have failed. Future studies surrounding this procedure should aim to assess generalizability of study findings across a larger patient population.