Purpose: Imipenem/Cilastatin has been utilized successfully to embolize collateral neovessels supplying tissues in a variety of inflammatory musculoskeletal conditions {1,2}. The purpose of this study is to evaluate safety, efficacy, and durability of outcomes at 1 year from Embozene microsphere embolization of the medial calcaneal artery for treatment of chronic plantar fasciitis.
Materials and Methods: Ten patients (median age 51 yrs, three with bilateral symptoms) with at least 12 months of pain over the medial calcaneal tubercle despite 6 months of conservative treatment, with radiologic signs of plantar fasciitis on ultrasound, and without underlying neuropathy or vascular disease were included in the study. A total of 13 procedures were performed by delivering 40- or 100-µm microspheres (Embozene, Varian) with or without coils via selective catheterization of the medial calcaneal artery. Baseline ultrasound of the plantar fascia was performed to assess thickness. Baseline and follow-up visual analogue scale (VAS) and foot and ankle disability index (FADI) scores were obtained.
Results: Technical success, defined as subselective catheterization and embolization to stasis of the medial calcaneal artery, was met in 100% of the cases. Mean baseline plantar fascia thickness was 6.0 mm. Mean baseline VAS and FADI was 91 mm and 54.9, respectively. After one month, mean decrease in the VAS was 79 mm (p< 0.001) and mean decrease in FADI was 38.8 (p< 0.001). After 12 months, mean decrease in the VAS was 86 mm (p< 0.001) and mean decrease in the FADI was 34.8 (p< 0.001). No adverse events were reported.
Conclusion: Transcatheter arterial embolization with Embozene microspheres is safe and effective in chronic plantar fasciitis with durability of success at 1 year. Longer-term follow-up with more patients is warranted.
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