Episode # 3 • 17 Jan 2025
Understanding Shoulder Embolization: Techniques & Patient Outcomes
For patients with frozen shoulder who have failed injections and months of physical therapy, can embolization offer relief when there are no good surgical options left? On this episode of the BackTable 2026 MSK Creator Weekend™, Dr. Anuj Malhotra of NYU Langone Hospital Long Island and Dr. Ahmed Farag of Advanced Vascular Institute in Panama City, Florida, join host Dr. Kavi Krishnasamy to examine shoulder embolization for adhesive capsulitis, osteoarthritis, and chronic rotator cuff tendinopathy. They cover the workup, how long to persist with conservative care, who makes the ideal candidate, and why the evidence outside adhesive capsulitis is still thin.
This podcast is supported by an educational grant from Guerbet.
Timestamps
00:00 - Introduction
01:42 - Conditions Treated and Patient Workup
06:17 - Conservative Therapy Before Embolization
09:22 - Patient Selection and the Ideal Candidate
12:25 - The Data Gap Beyond Adhesive Capsulitis
15:23 - Radial Access and Device Setup
17:27 - Target Vessels and Embolic Choice
21:36 - Collaterals, Cone Beam CT, and Endpoints
26:58 - Post-Procedure Care and Follow-Up
30:49 - Shoulder Embolization and the Rotator Interval
32:52 - Complications, Efficacy, and Durability
36:39 - Case Review
43:09 - Future Directions and Closing Remarks
Resources
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More about this episode
The conversation then moves into technique: ipsilateral radial access, shapeable microcatheters for a high radial takeoff, which circumflex humeral, thoracoacromial, and suprascapular branches to interrogate, and why both guests use imipenem-cilastatin and prune rather than push to stasis. They discuss caution near the suprascapular origin, collateral supply, cone beam CT, physical therapy, follow-up, and repeat treatment, along with a recent study showing less rotator interval inflammation on MRI after embolization. The episode closes with case images, including a firefighter who could raise his arm right after treatment for the first time in five years, and a look at where shoulder embolization may stand in five years.
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