Transcatheter Periarticular Embolization via Brachial Artery Access in Elderly Patients With Primary Hip Osteoarthritis: A Pilot Prospective Analysis

Background Hip osteoarthritis (HOA) is increasingly prevalent and imposes substantial economic and quality-of-life burdens. Vascular dysregulation is a modifiable pain driver. Transarterial embolization (TAE) of joint vessels is established for knee osteoarthritis, but prospective data for the hip are nonexistent. The main aim of this study was to evaluate mid-term pain relief and functional improvement after TAE in elderly patients with mild-to-advanced HOA who were ineligible for total hip arthroplasty. Secondary endpoints included assessing overall procedural safety and technical feasibility. Methodology In this prospective, single-arm study, a sample size of 18 consecutive patients (mean age ± SD = 67.2 ± 5.7 years; 11 women) with Tönnis grade I-II HOA, ≥1 surgical contraindication, and symptoms for >1 year underwent TAE via brachial access using Nexsphere-F™ bioresorbable microspheres (100-300 μm). Endpoints were changes in Visual Analog Scale (VAS) pain and Harris Hip Score (HHS) at one, four, eight, and twelve weeks versus baseline. Results VAS decreased from 7.8 ± 1.3 at baseline to 4.2 ± 2.0 at week one and 4.3 ± 2.2 at week twelve (Δ -3.5 points at 12 weeks; p < 0.01). HHS improved from 45.5 ± 4.7 at baseline to 59.9 ± 7.1 at week one and 62.1 ± 7.5 at week twelve (Δ +16.6 points; p < 0.01). No adverse events occurred. Conclusions Hip TAE produced rapid and durable reductions in pain and improvements in hip function without adverse events in elderly, surgery-ineligible HOA patients using brachial access and bioresorbable microspheres. These findings support TAE as a promising minimally invasive bridge between conservative therapy and arthroplasty.