Episode # 3 • 17 Jan 2025
Understanding Foot & Ankle Embolization Techniques
Heel pain that has outlasted stretching, orthotics, and physical therapy may come down to a few small abnormal vessels, and a growing number of interventional radiologists are now treating them with embolization. On this episode of the BackTable 2026 MSK Creator Weekend™, Dr. Osman Ahmed and Dr. Anuj Malhotra join host Dr. Ally Baheti to discuss embolization for plantar fasciitis and insertional Achilles tendinopathy. They describe the classic patient, the windlass test, point-of-care ultrasound to track fascia thickness, and how they counsel patients when the evidence is early and a second session is common.
This podcast is supported by an educational grant from Guerbet.
Timestamps
00:00 - Introduction
01:09 - Plantar Fasciitis: Patient Profile, Exam, and Ultrasound
04:56 - Antegrade Femoral Access and Embolic Preparation
07:45 - Sheathless Microcatheters Versus Posterior Tibial Access
11:13 - Success Rates and Counseling Patients
14:53 - Follow-Up, Repeat Treatment, and Chronic Symptoms
16:46 - Achilles Tendinopathy: Indications and Workup
19:58 - Achilles Arterial Supply and Case Review
24:22 - Contrast Choice for Ethiodized Oil Emulsions
27:12 - Permanent, Temporary, and Resorbable Embolics
31:38 - Plantar Fasciitis Case and a Fluoroscopy-Free Technique
36:03 - Patients with PAD and Closing Remarks
Resources
- Sasaki T, et al. Clinical results of ultrasound-guided intra-arterial embolization targeting abnormal neovessels for plantar fasciitis: 66 cases with up to 4 years of follow-up. Foot Ankle Surg. 2025
- Dr. Venkatesh (Kavi) Krishnasamy, BackTable contributor page https://backtable.com/shows/vi/contributors/dr-venkatesh-krishnasamy
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More about this episode
The conversation then turns to technique: antegrade femoral access with a base catheter versus a sheathless 1.7 French microcatheter, why a posterior tibial puncture can take five minutes or 45, how they mix imipenem-cilastatin, and an Achilles case treated with an ethiodized oil emulsion taken to stasis under live visualization. Drop-in appearances from Dr. Kavi Krishnasamy and Dr. Ahmed Farag spark a lively exchange on contrast choice, permanent versus temporary embolics, and what resorbable agents may change. The episode closes with a plantar fasciitis case, a fluoroscopy-free needle technique from a physician in Japan, and why the group holds back in patients with peripheral artery disease.
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