Musculoskeletal embolotherapy (MSK‑ET) is a minimally invasive treatment that reduces chronic pain and inflammation by selectively embolizing abnormal neovessels¹^,². Building on Dr. Yuji Okuno’s pioneering work³, the field has rapidly expanded over the past decade, with growing clinical indications and new embolic technologies⁴.​

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MSK-ET addresses hypervascularity linked to osteoarthritis, overuse or sports-related injuries^1,2,4,5​.

Clinical studies of genicular artery embolization (GAE) for knee osteoarthritis show meaningful pain and functional improvement, though sham‑controlled trials report mixed results—ranging from clear benefit to no significant difference when sham treatment also improved symptoms^6-11​​.

Other treatment targets may include - ​

• Shoulder (e.g. adhesive capsulitis)¹²​
• Hip (e.g. greater trochanteric pain syndrome)^13​
• Foot and ankle (e.g. plantar fasciitis, Achilles tendinopathy)^14-15​
• Elbow (e.g.  lateral epicondylitis a.k.a tennis elbow)^16​
• Other (e.g. temporomandibular joint osteoarthritis, hand/wrist osteoarthritis, patellar tendinopathy, myofascial pain syndromes)^17-20​

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Ideal candidates have chronic pain unresponsive to conservative therapy and imaging evidence of abnormal hypervascularity correlating with symptoms. ​

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Technical success depends on precise navigation into small, tortuous branches supplying the pain generator. This requires microcatheters of exceptional trackability, with versatile tip shapes for selective access to challenging branches. Combined with a stable guiding system, this enables accurate positioning and controlled embolic delivery, minimizing the risk of non-target embolization.​

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Protocols generally use temporary embolics to reduce off-target ischemic risk, while permanent embolics are being explored for longer durability in selected cases. The choice, however, depends on operator's discretion.​

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