Search Results (3)

Background/Objectives: Radial artery access (RAA) is widely used for catheter-based procedures due to its safety and convenience, but complex regional pain syndrome (CRPS) remains a rare, underrecognized complication—particularly in women. CRPS manifests as prolonged, severe pain and autonomic symptoms, often associated with nerve irritation near the carpal tunnel. This study aimed to evaluate whether modifying the puncture site to a high radial artery puncture (HRAP) reduces the risk of CRPS in patients undergoing transarterial micro-embolization (TAME) for frozen shoulder. Methods: We retrospectively reviewed 97 patients (47 women and 50 men) who underwent transarterial micro-embolization (TAME) via conventional RAA for frozen shoulder between February and June 2019. The occurrence of CRPS and vascular complications was recorded. All punctures were ultrasound-guided. Results: Among women treated via conventional RAA, five developed CRPS and one had radial artery occlusion. CRPS symptoms included intense puncture site pain (mean duration was 47 days), which severely impaired daily function. No complications occurred in men. Following the adoption of HRAP, no cases of CRPS, prolonged pain, or vascular complications were observed in the consecutive 101 women treated. Conclusions: Our findings suggest HRAP reduces CRPS risk by avoiding superficial nerve branches and targeting deeper arterial segments with fewer sensory structures. This ultrasound-guided modification is simple, does not require additional training, and may be widely applicable in both musculoskeletal and cardiovascular interventions. HRAP may help minimize neuropathic complications in broader patient populations. Full article

Objectives: To evaluate the impact of benzodiazepines (BZDs) on pre-procedural anxiety, procedural parameters, post-procedural pain, and satisfaction in transarterial microembolization (TAME). Methods: Retrospective analysis of prospectively collected data from 31 patients with refractory upper extremity pain treated with transradial TAME in 2023. Patients were divided into a non-BZD group (n = 15; 8 female; age 59.3 ± 9.5 y) and a BZD group (n = 16; 10 female; age 53.3 ± 9.9 y). Pre-procedural anxiety (five-point Likert scale), satisfaction (Likert), and pain (Visual Analog Scale, VAS) were assessed. Satisfaction and pain were evaluated immediately and 1 and 3 months post-procedure. Results: Baseline demographics, intra-procedural variables, and post-procedural reductions in VAS scores showed no significant intergroup differences (all p > 0.05). However, compared to the non-BZD group, the BZD group exhibited a significant reduction in anxiety scores (1.12 vs. 3.80; p = 0.04) and procedure time per artery (23.58 vs. 34.81 min; p = 0.001). The BZD group also reported significantly higher immediate, short-term, and mid-term satisfaction (4.25 vs. 3.13, p = 0.045; 4.69 vs. 3.67, p = 0.01; 4.81 vs. 3.80, p < 0.001), and a significantly greater proportion exhibited artery diameters ≥ 2 mm (p = 0.02). Conclusions: TAME with oral BZD premedication significantly improves patient satisfaction, reduces anxiety, and promotes a high proportion of arterial diameters ≥ 2 mm, thereby reducing procedural time. Full article

Transarterial microembolization (TAME) is an innovative approach to treating chronic musculoskeletal pain. During the procedure, intraprocedural vasospasm, presenting juxta-catheter stenosis, and poor distal artery perfusion and flow through the anastomosis commonly pose challenges. Difficulty of the catheter reaching the target vessel and restricted drug delivery are possible consequences. To address these issues, transcatheter nitroglycerin (NTG) infusion at the extremity’s small-sized artery has been introduced. We investigated patients who underwent the TAME procedure wherein NTG was employed and sourced from two institutional settings. Transcatheter NTG infusion was administered in seven instances of chronic musculoskeletal pain manifesting with intraprocedural vasospasm during TAME procedures. Patient profiles, preprocedural imaging, fluoroscopic findings, adverse events, and Numerical Rating Scale (NRS) scores were evaluated. As a result, all seven cases experiencing intraprocedural vasospasm exhibited rapid responses to transcatheter NTG infusion. Angiography conducted pre- and post-infusion demonstrated increased vessel size, resolved proximal catheter stenosis, and improved distal perfusion. One case presented an adverse effect of self-limited transient hypotension. The NRS scores decreased following the procedure. Transcatheter NTG infusion at the extremity’s small-sized muscular artery can be an effective technique for resolving intraprocedural vasospasm in TAME procedures, irrespective of the target diseases and approach vessels. Full article