Superselective embolization of the medial calcaneal artery: a minimally invasive and novel solution for rapid pain relief in plantar fasciitis.

PURPOSE: This study evaluated the efficacy and safety of superselective embolization of the medial calcaneal artery using imipenem/cilastatin in patients with chronic, treatment-resistant plantar fasciitis.

MATERIALS AND

METHODS

In this single-center prospective study, 32 patients (17 females, 15 males; mean age: 47.3 ± 9.1 years) with chronic plantar fasciitis unresponsive to conservative treatments underwent superselective embolization of the medial calcaneal artery using imipenem/cilastatin. In 31 patients (96.9 %), the target artery originated from the posterior tibial artery or lateral plantar artery; in one patient (3.1 %), it originated from the peroneal artery due to anatomical variations. Pain severity was assessed using the Visual Analog Scale (VAS), functional status with the Foot Function Index (FFI), and plantar fascia thickness using ultrasound imaging. Technical success, complications, and recurrence were recorded.

RESULTS

All procedures were technically successful, with no major or minor complications. The mean VAS score decreased from 7.3 ± 0.7 at baseline to 1.3 ± 0.5 at six months (p < 0.001), while the mean FFI score improved from 55.5 ± 4.9 to 20.4 ± 6.3 (p < 0.001). Plantar fascia thickness decreased from 5.2 ± 0.6 mm to 3.7 ± 0.3 mm at six months (p < 0.001). Minimal recurrence was observed in five patients (15.6 %) with physically demanding occupations and orthopedic heel insoles were recommended; however, no repeat embolization was required.

CONCLUSION

Superselective embolization of the medial calcaneal artery using imipenem/cilastatin represents a novel, safe, and minimally invasive strategy for rapid and sustained pain relief in patients with chronic plantar fasciitis.