4:03 PM Abstract No. 10 Angiographic analysis of arterial embolization of the shoulder for adhesive capsulitis

Abstract

Recent studies have demonstrated the successful use of arterial embolization of the shoulder (AES) for pain secondary to adhesive capsulitis. Given the limited angiographic analysis of the shoulder vasculature in the literature, we report angiographic findings and anatomical variations in patients undergoing AES for shoulder pain. Angiographic findings from 16 AES procedures performed to treat shoulder pain (NCT03676829) from January 2018 to September 2019 were reviewed to study the following vessels: suprascapular artery (SSA), thoracoacromial artery (TAA), coracoid branch (CB), circumflex scapular artery (CSA), anterior and posterior humeral circumflex artery (AHCA and PHCA). The diameter, angle of origin with respect parent vessel, and the branching pattern of each vessel was recorded. Additional measures included subclavian artery diameter (within 1 cm of SSA), fluoroscopy time, and the amount of particulate used. The average vessel diameters (mm) were CSA (4.3), PHCA (3.5), TAA (2.1), SSA (2.0), AHCA (1.4), and CB (0.9). The angle of origin (degrees), as measured 2.5 cm from the parent artery were CB (103), AHCA (99), CSA (71), SSA (61), PHCA (51), and TAA (41). 64 arteries were embolized in 16 subjects, with the TAA and CB most commonly treated (20.3%), followed by PHCA (18.8%), AHCA (17.2%), CSA (14.1%), and SSA (9.4%). A common origin was noted for CSA and PHCA (26.7%, n = 4), AHCA/PHCA (13.3%, n = 2), and CSA/AHCA/PHCA (13.3%, n = 2). The average subclavian artery diameter was 7.7 mm. An in-depth understanding of the angiographic shoulder anatomy is necessary to maximize technical success and improve patient outcomes.