title: Transcatheter arterial embolization using imipenem/cilastatin sodium for tendinopathy and enthesopathy refractory to nonsurgical management.
abstract: OBJECTIVE
  To evaluate the feasibility and effects of transcatheter arterial embolization with imipenem/cilastatin sodium (CS) to treat tendinopathy and enthesopathy that are refractory to traditional nonsurgical management.
  
  
  METHODS
  Transcatheter arterial embolization with imipenem/CS as an embolic agent was performed in seven patients (five men; mean age, 51.7 y) with tendinopathy and enthesopathy (patellar tendinopathy, n = 1; rotator cuff tendinopathy, n = 2; plantar fasciitis, n = 1; lateral epicondylitis, n = 1; iliotibial band syndrome, n = 1; and Achilles insertion tendinopathy, n = 1). All patients had unrelenting pain at the site of tendinopathy and enthesopathy before the procedure. Technical success, adverse events, and changes in visual analog scale (VAS) scores were assessed.
  
  
  RESULTS
  All procedures were technically successful, and no major adverse events developed. Compared with before the procedure, mean VAS scores were significantly decreased at 1 day, 1 week, and 1 and 4 months after the procedure (72.7 mm±9.9 vs 17.4 mm±18.5, 16.0 mm±18.1, 13.7 mm±7.3, and 9.7 mm±6.8, respectively; all P< .001).
  
  
  CONCLUSIONS
  Transcatheter arterial embolization with imipenem/CS was feasible and effectively relieved unrelenting pain associated with tendinopathy and enthesopathy.
authors.affiliation: Center for Integrated Medical Research, School of Medicine, Keio University, Tokyo, Japan. okunocatheter@a2.keio.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okuno
authors.forename: Noboru
authors.initials: N
authors.lastname: Matsumura
authors.forename: Sota
authors.initials: S
authors.lastname: Oguro
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D018771:Arthralgia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D002406:Catheterization, Peripheral / Q000379:methods*; D002908:Chronic Disease; D015377:Cilastatin / Q000008:administration & dosage*; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D011480:Protease Inhibitors / Q000008:administration & dosage; D012216:Rheumatic Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D052256:Tendinopathy / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D006490:Hemostatics; D011480:Protease Inhibitors; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination