Shoulder embolization (transarterial embolization): Patient Guide
What it is
With frozen shoulder (adhesive capsulitis) and some other long-lasting shoulder problems, the tissue around the joint can become inflamed and grow extra small blood vessels. This extra blood flow is linked with pain, especially at night. Shoulder embolization slows that blood flow. A very thin tube (catheter) is placed at the wrist or groin and guided to the small arteries around the shoulder, where tiny particles are released. There is no cut into the shoulder. It does not repair a torn tendon.
Who it may help
- Frozen shoulder (adhesive capsulitis) with pain that has lasted 3 months or more
- Shoulder pain, often worse at night, that has not improved with physical therapy, medicines or injections
- Some chronic shoulder pain from tendon inflammation, after an evaluation
- People who want to avoid or delay surgery, or who are not candidates for it
Who may not be a good fit
- Infection in or near the shoulder
- A large or full-thickness rotator cuff tear that may need a surgical evaluation
- Pain mainly from the neck or another source
- Serious kidney disease or a severe allergy to contrast dye
- A bleeding problem
- Pregnancy
Before
- Bring your X-rays, MRI reports and a list of your medicines.
- Tell us about blood thinners, diabetes, kidney problems, or an allergy to contrast dye or iodine.
- We may order a blood test to check your kidneys.
- Do not stop any medicine on your own. We will tell you what to do.
- Arrange a driver for the day of the procedure.
During
- Light sedation and numbing medicine at the wrist or groin.
- A thin catheter is guided with X-ray to small arteries near the shoulder.
- Tiny particles slow the extra blood flow.
- It often takes about 1 to 2 hours. Most people go home the same day.
After and recovery
- Keep the access site clean and dry. Avoid heavy lifting with that arm or leg for a few days.
- Most people return to light activity within a day or two.
- Some soreness in the joint, bruising at the access site, or a short-term skin color change over the joint can happen and usually fades.
- If pain improves, the change often builds over several weeks. Some people notice little or no change.
- Keep up with exercise or physical therapy as advised.
Risks
- Bruising, bleeding or a small lump where the catheter went in (wrist or groin)
- A reaction to the contrast dye, or strain on the kidneys from the dye
- Short-term skin color change, tenderness or a warm feeling over the treated joint
- Rarely, particles reach an area that was not intended, which can injure skin or other tissue
- Infection is uncommon
- Pain may not improve
When to call us
- Bleeding or a growing lump at the wrist or groin
- Fever over 101°F or chills
- A cold, pale, numb or very painful hand or foot
- Skin over the joint that becomes dark, blistered or open
- Pain much worse than before
Call 911 for chest pain or trouble breathing.
Questions people ask
Is shoulder embolization surgery?
No. It is a minimally invasive procedure done through a thin catheter at the wrist or groin. There is no cut into the shoulder.
Does it fix the shoulder?
No. It does not repair cartilage or tendons. It aims to reduce the abnormal blood flow linked with inflammation and pain.
How soon might I feel a change?
If it helps, the change often builds over several weeks. Results vary, and some people notice little or no change.
Will I stay overnight?
Most people go home the same day after a period of rest and monitoring. Plan to have a driver.
Can I still have other treatments later?
Yes. Embolization does not rule out physical therapy, injections or surgery later.
Insurance
Coverage for embolization varies. Many insurers consider genicular artery embolization, and embolization for the shoulder or hip, investigational, so it may not be covered. Our team will check your plan and talk with you about costs before anything is scheduled.
This handout is general information and is not a substitute for medical advice. Individual results vary. Photo: cottonbro studio / Pexels.