Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case Series

Transarterial microembolization (TAME) is an innovative approach to treating chronic musculoskeletal pain. During the procedure, intraprocedural vasospasm, presenting juxta-catheter stenosis, and poor distal artery perfusion and flow through the anastomosis commonly pose challenges. Difficulty of th...

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Main Authors: Kuan-Wei Li, Keng-Wei Liang, Wen-Ying Liao, Chien-Kuo Wang, Yi-Sheng Liu, Tai-Hua Yang, Chun-Hsin Wu, Bow Wang
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/14/11/1413
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author Kuan-Wei Li
Keng-Wei Liang
Wen-Ying Liao
Chien-Kuo Wang
Yi-Sheng Liu
Tai-Hua Yang
Chun-Hsin Wu
Bow Wang
author_facet Kuan-Wei Li
Keng-Wei Liang
Wen-Ying Liao
Chien-Kuo Wang
Yi-Sheng Liu
Tai-Hua Yang
Chun-Hsin Wu
Bow Wang
author_sort Kuan-Wei Li
collection DOAJ
description Transarterial microembolization (TAME) is an innovative approach to treating chronic musculoskeletal pain. During the procedure, intraprocedural vasospasm, presenting juxta-catheter stenosis, and poor distal artery perfusion and flow through the anastomosis commonly pose challenges. Difficulty of the catheter reaching the target vessel and restricted drug delivery are possible consequences. To address these issues, transcatheter nitroglycerin (NTG) infusion at the extremity’s small-sized artery has been introduced. We investigated patients who underwent the TAME procedure wherein NTG was employed and sourced from two institutional settings. Transcatheter NTG infusion was administered in seven instances of chronic musculoskeletal pain manifesting with intraprocedural vasospasm during TAME procedures. Patient profiles, preprocedural imaging, fluoroscopic findings, adverse events, and Numerical Rating Scale (NRS) scores were evaluated. As a result, all seven cases experiencing intraprocedural vasospasm exhibited rapid responses to transcatheter NTG infusion. Angiography conducted pre- and post-infusion demonstrated increased vessel size, resolved proximal catheter stenosis, and improved distal perfusion. One case presented an adverse effect of self-limited transient hypotension. The NRS scores decreased following the procedure. Transcatheter NTG infusion at the extremity’s small-sized muscular artery can be an effective technique for resolving intraprocedural vasospasm in TAME procedures, irrespective of the target diseases and approach vessels.
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spelling doaj-art-741fa830ddff49b993076453ab4888db2025-08-20T01:54:07ZengMDPI AGLife2075-17292024-11-011411141310.3390/life14111413Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case SeriesKuan-Wei Li0Keng-Wei Liang1Wen-Ying Liao2Chien-Kuo Wang3Yi-Sheng Liu4Tai-Hua Yang5Chun-Hsin Wu6Bow Wang7Department of Medical Imaging, National Cheng Kung University, Tainan 704, TaiwanDepartment of Medical Imaging, Chung Shan Medical University Hospital, Taichung 402, TaiwanDepartment of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 704, TaiwanDepartment of Medical Imaging, National Cheng Kung University, Tainan 704, TaiwanDepartment of Medical Imaging, National Cheng Kung University, Tainan 704, TaiwanDepartment of Biomedical Engineering, National Cheng Kung University, Tainan 704, TaiwanDepartment of Internal Medicine, Division of Allergy, Immunology, and Rheumatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, TaiwanDepartment of Medical Imaging, National Cheng Kung University, Tainan 704, TaiwanTransarterial microembolization (TAME) is an innovative approach to treating chronic musculoskeletal pain. During the procedure, intraprocedural vasospasm, presenting juxta-catheter stenosis, and poor distal artery perfusion and flow through the anastomosis commonly pose challenges. Difficulty of the catheter reaching the target vessel and restricted drug delivery are possible consequences. To address these issues, transcatheter nitroglycerin (NTG) infusion at the extremity’s small-sized artery has been introduced. We investigated patients who underwent the TAME procedure wherein NTG was employed and sourced from two institutional settings. Transcatheter NTG infusion was administered in seven instances of chronic musculoskeletal pain manifesting with intraprocedural vasospasm during TAME procedures. Patient profiles, preprocedural imaging, fluoroscopic findings, adverse events, and Numerical Rating Scale (NRS) scores were evaluated. As a result, all seven cases experiencing intraprocedural vasospasm exhibited rapid responses to transcatheter NTG infusion. Angiography conducted pre- and post-infusion demonstrated increased vessel size, resolved proximal catheter stenosis, and improved distal perfusion. One case presented an adverse effect of self-limited transient hypotension. The NRS scores decreased following the procedure. Transcatheter NTG infusion at the extremity’s small-sized muscular artery can be an effective technique for resolving intraprocedural vasospasm in TAME procedures, irrespective of the target diseases and approach vessels.https://www.mdpi.com/2075-1729/14/11/1413intraprocedural vasospasmvasospasmNTGTAMEmuscular artery
spellingShingle Kuan-Wei Li
Keng-Wei Liang
Wen-Ying Liao
Chien-Kuo Wang
Yi-Sheng Liu
Tai-Hua Yang
Chun-Hsin Wu
Bow Wang
Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case Series
Life
intraprocedural vasospasm
vasospasm
NTG
TAME
muscular artery
title Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case Series
title_full Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case Series
title_fullStr Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case Series
title_full_unstemmed Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case Series
title_short Nitroglycerin (NTG) Infusion for Intraprocedural Vasospasm in Transarterial Microembolization (TAME): A Case Series
title_sort nitroglycerin ntg infusion for intraprocedural vasospasm in transarterial microembolization tame a case series
topic intraprocedural vasospasm
vasospasm
NTG
TAME
muscular artery
url https://www.mdpi.com/2075-1729/14/11/1413
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