TAPE: Transarterial Periarticular Embolisation for Chronic Pain

Chronic joint pain occurs frequently in older age. With the method of joint artery embolisation, there is now a minimally invasive treatment alternative to conservative therapy.

Chronic musculoskeletal pain: (Not) a question of age?

You can be confronted with joint pain at any stage of life. While joint diseases such as arthrosis or rheumatism are more common triggers for permanent pain in older age, young sufferers can also suffer from it due to injuries, improper stresses, or congenital deformities. In addition, permanent pain can occur after the insertion of a joint endoprosthesis.

In such cases, conservative and surgical therapies do not always help sufficiently, which is why the method of genicular artery embolisation (GAE), also called transarterial periarticular embolisation (TAPE), was recently developed. It can be used for chronic joint pain caused, for example, by arthrosis or overuse of the tendon apparatus.1

Articular artery embolisation as a therapy option 

In joint artery embolisation, small particles are used to specifically interrupt the blood supply to the affected joint. This can relieve inflammation and pain - without having to surgically open the joint. 

The minimally invasive procedure works as follows: After a local anaesthetic, a very thin catheter is inserted via the groin into the vascular branches that supply the damaged area (joint, bursa, tendon insertion) with blood. Microparticles are then injected there, which significantly reduce the blood flow to the joint. With this targeted embolisation of the microcirculation, the over-supply of the inflamed joint areas is stopped. The stressed nerves can calm down, and the influx of messenger substances that maintain the inflammation is also reduced. This can lead to significant pain relief.

In addition to breaking the self-perpetuating inflammatory cycle, minimising the blood supply also has the effect of reducing the formation of hypersensitive nerve connections.

For who does TAPE make sense?

Generally speaking, TAPE makes sense for patients who do not respond sufficiently to conservative therapy - consisting of physiotherapy, infiltration treatments and pain medication. The procedure is performed as an inpatient and lasts about one hour. The next day, patients can leave the hospital and go about their daily lives again. Overall, the procedure has few risks and is suitable for large joints such as the knee, hip, shoulder and wrist.

Joint embolisation can be used to treat:

In addition, minimally invasive embolisation is suitable for patients who do not wish to undergo surgery or who would have an increased health risk with surgery (e.g. impaired heart or lung function).

TAPE is predominantly painless; if at all, the occurrence of pain during embolisation is possible. There may also be some local skin discolouration after the procedure, but this will disappear completely after one to two weeks at the latest.

Physicians who use the method describe TAPE as a gentle, quick treatment method that carries few risks. Embolisation provides rapid and, in most cases, longer-lasting pain relief. However, it should be noted that due to the relatively small number of people treated with TAPE, comprehensive long-term results are not yet available. In the treatment of knee joint osteoarthritis, the success rate of TAPE is over 80% four years after the procedure.2,3

References (in German only):
  1. Neue Therapieoption bei chronischen Gelenkschmerzen (In English: New therapy option for chronic joint pain). Helios: https://www.helios-gesundheit.de/unternehmen/aktuelles/pressemitteilungen/detail/news/neue-therapieoption-bei-chronischen-gelenkschmerzen/
  2. Embolisation bei chronischen Gelenkschmerzen (In English: Embolisation for chronic joint pain). Charité: https://radiologie.charite.de/interventionsradiologie/chronische_gelenkschmerzen/
  3. https://flexikon.doccheck.com/de/Transarterielle_periartikul%C3%A4re_Embolisation

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