Therapeutic Arterial Embolization in Patients with Shoulder Adhesive Capsulitis: A Systematic Review

Abstract

Introduction: Currently there are limited options for shoulder adhesive capsulitis treatment, some of which do not have sufficient backing scientific evidence. This entails a relevant setback for patients, especially in severe or refractory cases. In recent years, remote arterial embolization therapies have demonstrated usefulness in the management of diverse musculoskeletal conditions. This systematic review examines the therapeutic role of arterial embolization in patients with shoulder adhesive capsulitis. Methods: A systematic review of articles published to date was performed, according to the methodology in the Cochrane Systematic Reviews Manual (MECIR) and the PRISMA checklists. PubMed, Scopus, Google Scholar, three other databases and three trial registries were examined for relevant studies. The ROBINS-I tool was used for quality assessment of included studies. Results: Ninety four potential articles were found, seven of which were included. In the selected studies, arterial embolization was carried out in 127 patients, 113 of whom had abnormal vessels. In all studies, a reduction in pain and improvement in mobility was observed in less than six months after the procedure. There were no major adverse effects or recurrent symptoms reported. Due to large data heterogeneity, a meta-analysis was not performed. Three literature reviews were also included as part of the background discussion. Conclusions: Arterial embolization is an effective and safe treatment option in patients with shoulder adhesive capsulitis, resulting in reduced pain and restored joint function. Controlled randomized trials are required to evaluate the attributable effect of the technique to the reported clinical improvement.