Shoulder
Shoulder arterial embolization
The microvessels feeding chronic inflammation are closed with microparticles, reducing pain when medications are not enough.
How it is performed
In chronic musculoskeletal pain, small abnormal vessels develop alongside inflammation and the nerve endings responsible for pain. Through a percutaneous access of a few millimetres at the wrist or groin, a microcatheter is guided with angiography to these vessels, which are closed with microparticles or a temporary agent — the technique is also known in the literature as TAME (transcatheter arterial micro-embolization). The reduction of inflammatory vascularisation translates into a progressive reduction of pain.
Who it is for
- Chronic shoulder or knee pain resistant to conservative treatment
- Tendinopathies and osteoarthritis with marked hypervascularity on colour Doppler ultrasound
- Patients not (yet) candidates for surgery
Recovery
Same-day discharge after a few hours of observation. Light activity for 2-3 days; maximum benefit develops over 1-3 months.
Conditions treated in this area: calcific tendinopathy of the rotator cuff, frozen shoulder (adhesive capsulitis), subacromial bursitis.
Scientific evidence
Genicular artery embolization is the most extensively studied variant of this technique: sham-controlled randomised trials and dedicated systematic reviews document a significant reduction in pain in knee osteoarthritis, sustained over time, with mostly minor and transient complications. Its application to the shoulder is more recent and under study.
References on PubMed
- Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis
Bagla S, Piechowiak R, et al. — J Vasc Interv Radiol, 2022 · PMID 34610422
- Genicular artery embolization for knee osteoarthritis: A systematic review of sham-controlled randomized trials
Milhem F, Takhman M, et al. — J Orthop, 2025 · PMID 40766107
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of shoulder arterial embolization?
It is a minimally invasive endovascular procedure performed as a day-case, under local anaesthesia. The most common issues are transient: a small bruise or soreness at the access point, and in some cases a post-embolization syndrome with pain, a feeling of being unwell or a low-grade fever in the following days, manageable with medication. Relevant complications (contrast reaction, unintended embolization of nearby vessels, problems at the puncture site) are rare and are discussed one by one during the consultation, with the informed consent in hand.
How much does the shoulder arterial embolization cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "does it really work?" and "how long does the result last?". The honest answers come from the scientific literature cited on this page, not from online stories: they describe average results in groups of patients and do not guarantee an individual outcome. Reviews and experiences found in forums concern cases different from yours, often with different indications and techniques. During the consultation we review your imaging and I tell you frankly whether you are a good candidate, what alternatives exist and when another pathway is preferable.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.