Transcatheter Arterial Embolization as a Treatment for Chronic Pain due to Osteoarthritis

PURPOSE: To assess the efficacy and safety of transarterial embolization (TAE) for the treatment of temporomandibular joint osteoarthritis (TMJ-OA)-related symptoms.

MATERIALS AND METHODS: Three female patients were referred to our center for TAE after conservative and surgical TMJ treatments failed. Six TAE procedures were performed with bilateral treatments spaced four weeks apart. Following CBCT with maximal magnification and narrow collimation to confirm correct positioning of the microcatheter, superselective TAE was performed using Imipenem/Cilastatin mixed with contrast medium. Technical success was defined by successful embolization of the target vessel. Outcome measures included Oral Health Impact Profile-Temporomandibular Joint (OHIP-TMD) and Numeric Rating Scale (NRS) at baseline, 4 weeks and at 3 months intervals.

RESULTS: TAE was technically successful in all six procedures. No adverse events were recorded. Clinical follow-up data after 3 months are available for all three patients, one patient reached the 6-months follow-up. OHIP-TMD scores decreased from 38 to 31, 45 to 39, and 45 to 28, respectively. NRS pain scores improved from 9 to 6, 10 to 7, and 9 to 5, respectively.

CONCLUSION: TAE appears to be a feasible and safe minimally-invasive option for selected TMJ-OA patients with symptoms refractory to standard treatments. Further studies with larger cohorts and extended follow-up are warranted to confirm these preliminary findings.