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Transarterial microembolization (TAME) is a novel treatment option for chronic musculoskeletal pain, especially suitable for patients who have not responded to conservative treatment or are unsuitable for surgical procedures. This minimally invasive technique primarily targets abnormal neovascularization for embolization, relying heavily on precise information provided by various imaging techniques to ensure the effectiveness and safety of the treatment. This study aims to explore the application of integrating preoperative magnetic resonance imaging (MRI) evidence of patient pain and intraoperative high-resolution synchronous imaging information from fused computed tomography (CT) and angiography systems. This integration is intended to enhance preoperative planning, intraoperative guidance, and final treatment outcome assessment, focusing on its crucial contribution to treatment success. It is hoped that this approach will provide pain intervention physicians with reliable diagnostic tools and safe treatment methods, thereby improving treatment outcomes for patients with chronic musculoskeletal pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAME responder | Transarterial microembolization (TAME) is performed on all included patients with chronic shoulder or knee joint pain. Responders are determined if pain score reduction is two points or more based on the Visual Analogue Scale (VAS) at 1-month follow-up after the TAME. |
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| TAME non-responder | Transarterial microembolization (TAME) is performed on all included patients with chronic shoulder or knee joint pain. Non-responders are determined if pain score reduction is less than two points or if pain score increases based on the Visual Analogue Scale (VAS) at 1-month follow-up after the TAME. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transarterial microembolization (TAME) | Procedure | TAME primarily targets abnormal neovascularization for embolization in chronic shoulder or knee joint pain. |
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| Measure | Description | Time Frame |
|---|---|---|
| Pain relief | Pain relief is measured according to the Visual Analog Scale (VAS) immediately prior to (baseline) and after the TAME procedure (day 0) as well as day 1, week 1, month 1, month 3, and month 6. | day 0, day 1, week 1, month 1, month 3, and month 6. |
| Measure | Description | Time Frame |
|---|---|---|
| Functional improvement (for shoulder joint) | Functional improvement is measured according to Shoulder Pain and Disability Index (SPADI) for patients with chronic shoulder pain immediately prior (baseline) to and after the TAME procedure (day 0) as well as day 1, week 1, month 1, month 3, and month 6. | day 0, day 1, week 1, month 1, month 3, and month 6. |
| Measure | Description | Time Frame |
|---|---|---|
| The technical success rate of TAME procedure | The technical success rate is judged according to the digital subtraction angiography (DSA). A successful procedure is determined by decreased neovascularization via targeted vessels embolization by the fused CT and angiography system. | Immediately after the TAME procedure |
Inclusion Criteria:
Exclusion Criteria:
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Patients with chronic musculoskeletal shoulder or knee joint pain who undergo preoperative magnetic resonance imaging (MRI) and receive transarterial microembolization (TAME) performed using fused computed tomography (CT) and angiography systems.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yi-Chih Hsu, M.D. | Contact | +886-2-8792 3311 | 13661 | doc31578@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Yi-Chih Hsu, M.D. | Tri-Service General Hospital, National Defense Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tri-Service General Hospital | Recruiting | Taipei | Taiwan |
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| Functional improvement (for knee joint) | Functional improvement is measured according to the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for patients with chronic knee pain immediately prior (baseline) to and after the TAME procedure (day 0) as well as day 1, week 1, month 1, month 3, and month 6. | day 0, day 1, week 1, month 1, month 3, and month 6. |