Skip to main content

Advertisement

Log in

Effects of Transcatheter Arterial Microembolization on Persistent Trapezius Myalgia Refractory to Conservative Treatment

  • Clinical Investigation
  • Embolisation (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the safety and efficacy of transcatheter arterial microembolization for patients with trapezius myalgia.

Materials and Methods

We retrospectively evaluated the prospectively collected data of patients with trapezius myalgia for > 6 months who were refractory to conservative treatment and were treated by transcatheter arterial microembolization between October 2017 and January 2019. Transcatheter arterial microembolization was performed using imipenem/cilastatin on the vessels of the transverse cervical artery, suprascapular artery, and circumflex scapular artery according to the region of pain.

Results

Forty-two patients were treated by transcatheter arterial microembolization and followed up for 6 months. No major adverse events occurred related to the procedures. The brief pain inventory worst pain scores significantly improved at 1, 2, 3, and 6 months after transcatheter arterial microembolization (8.6 ± 1.3 (before procedure) vs. 5.1 ± 2.9, 4.4 ± 2.9, 4.1 ± 2.8, and 3.9 ± 2.9, respectively, P < 0.001). The brief pain inventory pain interference scores, including general activity, mood, walking ability, normal work, relations with others, sleep, and enjoyment of life, also significantly decreased at 1, 2, 3, and 6 months after transcatheter arterial microembolization compared to those at baseline (all P < 0.01). The clinical success rate at 6 months after transcatheter arterial microembolization was 71.4% (95% confidence interval, 55.4–84.3%).

Conclusion

Transcatheter arterial microembolization is a safe and effective treatment for persistent trapezius myalgia. Further evaluation with a control group is needed to confirm the effects of transcatheter arterial microembolization.

Level of Evidence

Level 4, Case Series.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

BPI:

Brief pain inventory

EVF:

Early venous filling

FM:

Fibromyalgia

IPM/CS:

Imipenem/cilastatin

TAME:

Transcatheter arterial microembolization

TM:

Trapezius myalgia

References

  1. van Tulder M, Malmivaara A, Koes B. Repetitive strain injury. Lancet. 2007;369:1815–22.

    Article  Google Scholar 

  2. Xie YF, Szeto G, Madeleine P, Tsang S. Spinal kinematics during smartphone texting: a comparison between young adults with and without chronic neck-shoulder pain. Appl Ergon. 2018;68:160–8.

    Article  Google Scholar 

  3. Cote P, Kristman V, Vidmar M, Van Eerd D, Hogg-Johnson S, Beaton D, Smith PM. The prevalence and incidence of work absenteeism involving neck pain: a cohort of Ontario lost-time claimants. Spine (Phila Pa 1976). 2008;33:S192–S198198.

    Article  Google Scholar 

  4. De Meulemeester K, Calders P, De Pauw R, Grymonpon I, Govaerts A, Cagnie B. Morphological and physiological differences in the upper trapezius muscle in patients with work-related trapezius myalgia compared to healthy controls: a systematic review. Musculoskelet Sci Prac. 2017;29:43–51.

    Article  Google Scholar 

  5. Taimela S, Takala EP, Asklof T, Seppala K, Parviainen S. Active treatment of chronic neck pain: a prospective randomized intervention. Spine (Phila Pa 1976). 2000;25:1021–7.

    Article  CAS  Google Scholar 

  6. Gross AR, Hoving JL, Haines TA, et al. Manipulation and mobilisation for mechanical neck disorders (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd., 2004.

  7. Iwamoto W, Okuno Y, Matsumura N, Kaneko T, Ikegami H. Transcatheter arterial embolization of abnormal vessels as a treatment for lateral epicondylitis refractory to conservative treatment: a pilot study with a 2-year follow-up. J Shoulder Elb Surg. 2017;26:1335–411.

    Article  Google Scholar 

  8. Okuno Y, Korchi AM, Shinjo T, Kato S. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis. Cardiovasc Intervent Radiol. 2015;38:336–43.

    Article  Google Scholar 

  9. Okuno Y, Oguro S, Iwamoto W, Miyamoto T, Ikegami H, Matsumura N. Short-term results of transcatheter arterial embolization for abnormal neovessels in patients with adhesive capsulitis: a pilot study. J Shoulder Elb Surg. 2014;23:e199–206.

    Article  Google Scholar 

  10. Hwang JH, Park SW, Kim KH, Lee SJ, Oh KS, Chung SW, Moon SG. Early results of transcatheter arterial embolization for relief of chronic shoulder or elbow pain associated with tendinopathy refractory to conservative treatment. J Vasc Interv Radiol. 2018;29:510–7.

    Article  Google Scholar 

  11. Lee SH, Hwang JH, Kim DH, So YH, Park J, Cho SB, Kim JE, Kim YJ, Hur S, Jae HJ. Clinical outcomes of transcatheter arterial embolisation for chronic knee pain: mild-to-moderate versus severe knee osteoarthritis. Cardiovasc Intervent Radiol. 2019;42:1530–6.

    Article  Google Scholar 

  12. Bagla S, Piechowiak R, Hartman T, Orlando J, Del Gaizo D, Isaacson A. Genicular artery embolization for the treatment of knee pain secondary to osteoarthritis. J Vasc Interv Radiol. 2020;31:1096–102.

    Article  Google Scholar 

  13. Ohta H, Nakano S, Yokogami K, Iseda T, Yoneyama T, Wakisaka S. Appearance of early venous filling during intra-arterial reperfusion therapy for acute middle cerebral artery occlusion: a predictive sign for hemorrhagic complications. Stroke. 2004;35:893–8.

    Article  Google Scholar 

  14. Okuno Y, Iwamoto W, Matsumura N, Oguro S, Yasumoto T, Kaneko T, Ikegami H. Clinical outcomes of transcatheter arterial embolization for adhesive capsulitis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28(2):161–7.e1.

    Article  Google Scholar 

  15. Woodhams R, Nishimaki H, Ogasawara G, Fujii K, Yamane T, Ishida K, Kashimi F, Matsunaga K, Takigawa M. Imipenem/cilastatin sodium (IPM/CS) as an embolic agent for transcatheter arterial embolisation: a preliminary clinical study of gastrointestinal bleeding from neoplasms. SpringerPlus. 2013;2:344.

    Article  Google Scholar 

  16. Tan G, Jensen MP, Thornby JI, Shanti BF. Validation of the Brief Pain Inventory for chronic nonmalignant pain. J Pain. 2004;5:133–7.

    Article  Google Scholar 

  17. Omary RA, Bettmann MA, Cardella JF, Bakal CW, Schwartzberg MS, Sacks D, Rholl KS, Meranze SG, Lewis CA. Society of Interventional Radiology Standards of Practice Committee. quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol. 2003;14(9 Pt 2):S293–S295295.

    Article  Google Scholar 

  18. Strom V, Roe C, Knardahl S. Work-induced pain, trapezius blood flux, and muscle activity in workers with chronic shoulder and neck pain. Pain. 2009;144:147–55.

    Article  Google Scholar 

  19. Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL. Excessive peptidergic sensory innervation of cutaneous arteriole-venule shunts (AVS) in the palmar glabrous skin of fibromyalgia patients: implications for widespread deep tissue pain and fatigue. Pain Med. 2013;14:895–915.

    Article  Google Scholar 

  20. Yoshida K, Ito H, Furuya K, Ukichi T, Noda K, Kurosaka D. Angiogenesis and VEGF-expressing cells are identified predominantly in the fascia rather than in the muscle during the early phase of dermatomyositis. Arthritis Res Ther. 2017;19:272.

    Article  Google Scholar 

  21. Gerdle B, Hilgenfeldt U, Larsson B, Kristiansen J, Søgaard K, Rosendal L. Bradykinin and kallidin levels in the trapezius muscle in patients with work-related trapezius myalgia, in patients with whiplash associated pain, and in healthy controls: a microdialysis study of women. Pain. 2008;139:578–87.

    Article  CAS  Google Scholar 

  22. Gerdle B, Kristiansen J, Larsson B, Saltin B, Søgaard K, Sjøgaard G. Algogenic substances and metabolic status in work-related Trapezius Myalgia: a multivariate explorative study. BMC Musculoskelet Disord. 2014;15:357.

    Article  Google Scholar 

  23. Ghafouri B, Larsson BK, Sjörs A, Leandersson P, Gerdle BUC. Interstitial concentration of serotonin is increased in myalgic human trapezius muscle during rest, repetitive work and mental stress-an in vivo microdialysis study. Scand J Clin Lab Invest. 2010;70:478–86.

    Article  CAS  Google Scholar 

  24. Kanbe K, Inoue K, Inoue Y, Chen Q. Inducement of mitogen-activated protein kinases in frozen shoulders. J Orthop Sci. 2009;14:56–61.

    Article  CAS  Google Scholar 

  25. De Meulemeester K, Calders P, Van Dorpe J, De Pauw R, Petrovic M, Cagnie B. Morphological differences in the upper trapezius muscle between female office workers with and without trapezius myalgia: Facts or fiction?: a cross-sectional study. Am J Phys Med Rehabil. 2019;98:117–24.

    Article  Google Scholar 

  26. Huntoon MA. Anatomy of the cervical intervertebral foramina: vulnerable arteries and ischemic neurologic injuries after transforaminal epidural injections. Pain. 2005;117:104–11.

    Article  Google Scholar 

  27. Fernández-de-Las-Peñas C, Ge H-Y, Arendt-Nielsen L, Cuadrado ML, Pareja JA. Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache. Eur J Pain. 2007;11:475–82.

    Article  Google Scholar 

  28. Kaniecki RG. Migraine and tension-type headache: an assessment of challenges in diagnosis. Neurology. 2002;58(9 Suppl 6):S15–20.

    Article  Google Scholar 

Download references

Funding

This study was not supported by any funding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yuji Okuno.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study is retrospective study; formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 1548 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shibuya, M., Sugihara, E., Miyazaki, K. et al. Effects of Transcatheter Arterial Microembolization on Persistent Trapezius Myalgia Refractory to Conservative Treatment. Cardiovasc Intervent Radiol 44, 102–109 (2021). https://doi.org/10.1007/s00270-020-02670-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-020-02670-8

Keywords

Navigation