What question did this study set out to answer?

The aim is to assess outcomes of TAE using KIPZA for adhesive capsulitis unresponsive to conservative treatments.

June 17, 2026Open Access

Transarterial Embolization for Adhesive Capsulitis (“Frozen Shoulder”): A Single-Centre Retrospective Study of 40 Patients Using Temporary Embolic Agent – KIPZA

MBMohal BankerAhmedabad Civil Hospital RGRozil GandhiAhmedabad Civil Hospital AGAditi Rozil GandhiAhmedabad Civil Hospital

Key Points

The aim is to assess outcomes of TAE using KIPZA for adhesive capsulitis unresponsive to conservative treatments.
Retrospective analysis of 40 patients with adhesive capsulitis treated with TAE from January 2020 to March 2024.
Included patients had significant pain and failed conservative management for at least three months.
Outcomes tracked included technical and clinical success evaluated at 3 months.
Achieved 100% technical success in all patients.
80% of patients reported clinical success at 3 months with significant pain and function improvements (p < 0.001).
Minor adverse events were noted, including transient erythema in 5% and temporary post-embolization ache in 20%.

Abstract

Abstract The aim of the study is to report technical and clinical outcomes of transarterial embolization (TAE) using kinetically inert polymeric zinc-alginate (KIPZA; ENGAIN, South Korea ) for adhesive capsulitis (AC) refractory to conservative management in a real-world single-center cohort. In this IRB-approved retrospective study, we reviewed data from consecutive patients with idiopathic or secondary AC treated with TAE between January 2020 and March 2024. Inclusion criteria were: (a) pain ≥6/10 on a 10-point visual analogue scale (VAS), (2) failure of ≥3 months of structured physiotherapy plus either intra-articular steroid injection or hydrodistension, and (3) imaging findings supporting AC, including restricted passive external rotation and capsular changes on MRI or US. Exclusions were prior capsular release within 12 months, full-thickness rotator cuff tear requiring repair, inflammatory arthropathy, active infection, or pregnancy. Embolization targeted angiographic hyperemia and neovascularity arising from branches of the thoracoacromial, anterior or posterior circumflex humeral, subscapular, and suprascapular arteries, using KIPZA (ENGAIN, South Korea) in 87.5% of the patients and microspheres in 12.5%. Outcomes included technical success (completion of planned target-vessel embolization with stasis or marked flow reduction) and clinical success (≥30% reduction in VAS score and ≥15-point improvement in American Shoulder and Elbow Surgeons score (ASES) or ≥20-point reduction in Shoulder Pain and Disability Index) at 3 months. Secondary outcomes were range of motion (ROM), analgesic use, repeat procedures, and adverse events (AEs). Forty patients (mean age, 53.1 ± 9.2 years) underwent TAE; 28 (70%) had idiopathic AC and 12 (30%) postoperative or diabetes-associated AC. Technical success was 100%. Thirty-two patients (80%) achieved clinical success at 3 months, which was maintained at 6 and 12 months in those with follow-up. Mean VAS and ASES scores improved at 3 months (p < 0.001). Minor AEs included transient cutaneous erythema at the shoulder (5%) and post-embolization ache resolving within 72 hours (20%). No skin necrosis, osteonecrosis, or infection was observed. TAE for refractory AC was feasible with 100% technical success, 80% clinical success, meaningful improvements in pain, function ROM, and a favorable safety profile.

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