Ankle and foot
Plantar fasciitis embolization
A minimally invasive treatment for refractory chronic plantar fasciitis: microspheres occlude the small abnormal vessels (neovessels) that feed the inflammation of the fascia, without incisions or injections into the heel.
How it is performed
When plantar fasciitis fails to respond to physiotherapy, orthotics, shockwave therapy and injections, the cause of chronic pain is often the proliferation of small abnormal blood vessels (neovessels) within the inflamed fascia. Embolization — also known as TAME (transcatheter arterial micro-embolization) — is an interventional radiology procedure that reaches these vessels from within: with a very small catheter introduced through the leg artery, under angiographic guidance, the arteries supplying the plantar fascia are reached and biocompatible microspheres are released, occluding the abnormal branches and removing the “fuel” of inflammation. There are no incisions, no needles touch the fascia, and the access point is a few millimetres. It is performed as a day-case procedure with a short period of observation.
Who it is for
- Chronic plantar fasciitis (>6 months) resistant to physiotherapy, orthotics, shockwave therapy and ultrasound-guided injections
- Persistent heel pain with the first steps in the morning that limits walking
- Patients who wish to avoid open surgery (fasciotomy)
Recovery
Relative rest for 24-48 hours with protected heel offloading; gradual return to walking. Benefit develops over the following weeks as the neovessels are reduced.
Conditions treated in this area: ankle (tibiotalar) osteoarthritis, sinus tarsi / subtalar joint osteoarthritis, plantar fasciitis and heel pain, achilles tendinopathy and tendon sheath disorders (posterior tibial, peroneal).
Scientific evidence
The Japanese pilot study that introduced this technique and subsequent prospective case series on transarterial embolization for refractory plantar fasciitis show a marked reduction in pain, maintained at follow-up, with a favourable safety profile. This is an emerging technique indicated for cases that have not responded to conventional treatments.
References on PubMed
- Early outcomes of transcatheter arterial embolization using imipenem/cilastatin for plantar fasciitis refractory to conservative therapy
Gandhi R, Banker M — Br J Radiol, 2024 · PMID 38281074
- Transcatheter arterial embolization using imipenem/cilastatin sodium for tendinopathy and enthesopathy refractory to nonsurgical management
Okuno Y, Matsumura N, Oguro S — J Vasc Interv Radiol, 2013 · PMID 23707086
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of plantar fasciitis embolization?
It is a minimally invasive endovascular procedure performed as a day-case, under local anaesthesia. The most common issues are transient: a small bruise or soreness at the access point, and in some cases a post-embolization syndrome with pain, a feeling of being unwell or a low-grade fever in the following days, manageable with medication. Relevant complications (contrast reaction, unintended embolization of nearby vessels, problems at the puncture site) are rare and are discussed one by one during the consultation, with the informed consent in hand.
How much does the plantar fasciitis embolization cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "does it really work?" and "how long does the result last?". The honest answers come from the scientific literature cited on this page, not from online stories: they describe average results in groups of patients and do not guarantee an individual outcome. Reviews and experiences found in forums concern cases different from yours, often with different indications and techniques. During the consultation we review your imaging and I tell you frankly whether you are a good candidate, what alternatives exist and when another pathway is preferable.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.