🎯 What is lateral epicondylitis?
Lateral epicondylitis, commonly known as "tennis elbow", is a painful tendinopathy at the insertion of the lateral epicondylar muscles on the lateral epicondyle of the elbow. It affects both athletes and people performing repetitive professional movements.
Pain is located on the outer side of the elbow, sometimes radiating to the forearm, worsened by gripping, handshaking, or resisted wrist extension. It can become disabling and resistant to standard treatments.
🔬 How does embolization work?
In chronic epicondylitis, the tendon develops pathological new blood vessels (neovascularisation) accompanied by sensitive nerve endings. This neovascularisation sustains pain through a neurogenic inflammation mechanism.
Embolization selectively occludes these pathological micro-vessels by injecting calibrated microspheres (75–100 µm) into the anterior radial recurrent artery. By reducing abnormal blood supply, the substrate of chronic pain is eliminated.
📋 Indications
- Lateral epicondylitis persisting for more than 3–6 months
- Failure of at least 2 corticosteroid injections
- Failure of well-conducted eccentric physiotherapy
- Neovascularisation confirmed on Doppler ultrasound
- Significant pain (VAS ≥ 4/10) affecting quality of life or work
🔧 The procedure
Pre-procedure workup: Doppler ultrasound of the elbow confirming neovascularisation, standard blood tests, stop anti-inflammatory drugs 5 days before.
Day case: arrive in the morning, leave the same day. Local anaesthesia at the wrist or elbow puncture site.
Selective arteriography under fluoroscopic guidance: hypersective catheterisation of the anterior radial recurrent artery branches feeding the pathological area.
Embolization: injection of calibrated microspheres into the pathological neovessels. Arteriographic control confirming occlusion.
Total duration: 45–90 minutes. 2–3 hours observation. Return home the same day.
🏥 Recovery
- Mild elbow pain for 24–48h, treated with paracetamol
- No cast or immobilisation required
- Return to light activities next day
- Sports resumed progressively at 4–6 weeks
- Progressive improvement over 4–12 weeks
- Ultrasound and follow-up consultation at 3 months
📊 Results
📄 Patient Information Sheet
Tennis Elbow Embolization — Patient Information
Download before your consultation.
✅ Covered by French National Health Insurance (Assurance Maladie) · No extra fees · Cochin University Hospital AP-HP