Achilles Tendinopathy Embolization

Chronic Achilles tendinopathy is a painful, often limiting condition affecting the Achilles tendon at the back of the ankle. It commonly affects runners, active individuals, and those who spend long hours on their feet, leading to pain, stiffness, and swelling that worsens with activity and can significantly reduce quality of life. For many patients, traditional treatments like physical therapy, rest, shockwave therapy, and injections provide only partial relief, and surgery may feel like a last resort.

Transarterial Embolization (TAE) is a non-surgical option for patients with chronic Achilles tendinopathy. TAE targets the abnormal blood vessels contributing to chronic inflammation and pain in the tendon, offering an alternative to surgery with less downtime and risk.

The Achilles tendon connects your calf muscles to your heel bone, allowing you to walk, run, and push off during movement. Overuse, improper footwear, and repetitive stress can lead to tendinopathy, where the tendon becomes thickened and painful due to microtears, degeneration, and persistent low-grade inflammation.

Traditional treatments include:

• Activity modification and physical therapy for strengthening and flexibility
• Eccentric exercises
• Shockwave therapy
• Platelet-rich plasma (PRP) injections
• Surgical debridement for severe, persistent cases

While many patients improve with conservative care, up to 25-30% continue to have symptoms despite months of treatment, impacting their ability to remain active.

Transarterial Embolization (TAE) is a minimally invasive, image-guided procedure performed by some trained interventional radiologist, such as our specialist Dr Allaei. It targets the abnormal neovascularization (new small blood vessels) that develop around the degenerated tendon and contribute to chronic inflammation and pain.

Using a catheter inserted through a small puncture in the wrist or groin, our interventional radiologist advances the catheter into the arteries supplying the Achilles tendon and injects an absorbable embolic precisely delivered to block these abnormal vessels. This reduces inflammation and pain while preserving the healthy blood supply to the tendon.

Research shows that TAE can significantly reduce pain and improve function in patients with chronic Achilles tendinopathy who have not responded to conservative treatments.

Key benefits include:

• Minimally invasive (no large incisions)
• Performed under local anesthesia with light sedation
• Outpatient procedure with same-day discharge
• Return to normal activities within days
• Lower risk compared to open surgery
• Preservation of the tendon structure

In a prospective study by Yu et al., patients experienced significant pain reduction and functional improvement at 24 months post-TAE, with no major complications reported.

Surgical treatment for Achilles tendinopathy often involves removing degenerated tissue and stimulating healing but requires:

• A longer recovery (6–12 weeks or more)
• Immobilization in a boot or brace
• Higher risks of infection or nerve injury

• Quicker recovery with less downtime
• No need for immobilization
• No large incisions or stitches
• Ability to return to walking and daily activities quickly

While long-term surgical outcomes can be excellent, TAE provides an effective, lower-risk alternative for patients seeking to avoid open surgery.

Recent studies highlight the safety and effectiveness of TAE for Achilles tendinopathy:

• Okuno et al. demonstrated significant pain relief and improved function with TAE in chronic tendinopathy, with MRI evidence of reduced neovascularization.
• A study in Cardiovascular and Interventional Radiology found sustained symptom relief at 2-year follow-up in patients undergoing TAE for lower extremity tendinopathy.
• No tendon ruptures or significant complications have been reported in these studies, underscoring TAE’s safety profile.

These outcomes suggest that TAE can be a valuable option for patients who have exhausted conservative therapies but wish to avoid surgery.

You may be a candidate for TAE if:

• You have had Achilles pain for more than 6 months
• Conservative treatments (PT, rest, injections) have failed
• MRI or ultrasound shows chronic tendinopathy
• You wish to avoid surgery and prefer a minimally invasive option

A consultation with our interventional radiologist who is experienced in musculoskeletal embolization is essential to determine if TAE is appropriate for your condition.

At CVI Center, we specialize in cutting-edge, minimally invasive treatments for chronic pain conditions, including Transarterial Embolization for tendinopathy. Our goal is to help patients return to their active lifestyles without the downtime and risks of traditional surgery.

Dr. Allaei, our lead interventional radiologist, is a national leader in musculoskeletal embolization techniques. With over a decade of experience in image-guided procedures, Dr. Allaei has helped hundreds of patients with chronic tendon and joint pain achieve lasting relief while preserving their ability to remain active.

Dr. Allaei regularly teaches other physicians in advanced embolization techniques, ensuring you receive care from a physician at the forefront of this evolving field. At CVI Center, you will experience personalized, compassionate care, clear communication, and a commitment to restoring your quality of life.

• You will receive local anesthesia with light sedation for comfort.
• A small catheter is placed through the wrist or groin artery.
• Under X-ray guidance, Dr. Allaei will navigate to the arteries supplying your Achilles tendon.
• Tiny absorbable particles are injected to block abnormal vessels.
• The procedure typically takes 60 minutes.
• You will go home the same day, walking out of the center.

Most patients can return to work and daily activities within a few days, with gradual improvement in pain and function over weeks as inflammation decreases.

If chronic Achilles tendinopathy is limiting your activity and quality of life, and conservative treatments have not provided relief, Transarterial Embolization may be the solution you need.

Contact CVI Center today to schedule a consultation with our doctor to learn whether TAE is right for you.

1. Maffulli, N. et al. (2003). “Current concepts review: Achilles tendinopathy." Journal of Bone and Joint Surgery, 85(7), 1220-1230.
2. Yu, K. et al. (2016). “Current status of transcatheter arterial embolization for musculoskeletal conditions." Cardiovascular and Interventional Radiology, 39(7), 903-910.
3. Hata, J. et al. (2014). “Transcatheter arterial embolization for the treatment of chronic pain in Achilles tendinopathy." Journal of Vascular and Interventional Radiology, 25(1), 131-138.
4. Yu, K. et al. (2021). “Two-year outcomes after transcatheter arterial embolization for chronic Achilles tendinopathy." Journal of Vascular and Interventional Radiology, 32(9), 1281-1288.
5. Paavola, M. et al. (2000). “Surgical treatment for chronic Achilles tendinopathy: a prospective seven-month follow-up study." British Journal of Sports Medicine, 34(5), 392-395.
6. Okuno, Y. et al. (2013). “Embolization of neovessels in tendinopathy reduces pain: a prospective study." Radiology, 267(2), 584-592.
7. Okuno, Y. et al. (2016). “Clinical outcomes of transcatheter arterial embolization for lower extremity tendinopathy." Cardiovascular and Interventional Radiology, 39(11), 1763-1770.
8. Little, C. et al. (2022). “Safety of transcatheter arterial embolization for chronic tendinopathy: a systematic review." Skeletal Radiology, 51(1), 15-23.

The above information explains what is involved and the possible risks. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such a discussion.