SIR 2024
Pain Management/MSK
Jade Lerner, MD (she/her/hers)
Resident
Rutgers New Jersey Medical School
Financial relationships: Full list of relationships is listed on the CME information page.
Abin Sajan, MD
Resident
Columbia Irving Medical Center
Financial relationships: Full list of relationships is listed on the CME information page.
Rachel Piechowiak, MD
Vascular & Interventional Radiologist
Prostate Centers USA
Disclosure information not submitted.
Ari Isaacson, MD, FSIR
Interventional Radiologist; Chair of Quality & Research
Prostate Centers USA
Disclosure information not submitted.
Alex Pavidapha, MD
Vascular & Interventional Radiologist
Prostate Centers USA
Disclosure information not submitted.
To evaluate the feasibility and technical considerations of femoral circumflex artery embolization (FCAE) in patients with symptomatic hip pain refractory to conservative management.
Materials and Methods:
Retrospective chart review was conducted for patients who underwent FCAE between July and September 2023. Five patients (66 ± 6 years, BMI 30.4 ± 5.1) underwent FCAE via transfemoral artery access with imipenem/cilastatin (IPM/CS). Angiography was used to identify the hyperemic synovium corresponding to the region of subjective pain, serving as the target embolic. Demographics, procedure details, technical success, visual analogue scale (VAS), and peri-procedural complications were recorded.
Results:
All cases were technically successful, defined as successful embolization of the femoral circumflex arteries supplying the area of palpable pain. In total, 3 middle femoral circumflex arteries (MFCA) and 5 left femoral circumflex arteries (LFCA) were embolized. The mean dose-area product and fluoroscopy time were 105.4 (±49.7) Gy.cm2 and 17.3 (±6.3) minutes, respectively. Mean VAS improved from 72.5 (± 32.8) mm to 25 (± 21.8) mm (N=4, p = 0.084) at the 1 month follow up. No significant adverse events were reported.
Conclusion:
Early studies indicate that MFCA and LFCA embolization may be an effective treatment for patient with hip pain refractory to conservative management.