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Cochin University Hospital – AP-HP · Paris Cité University
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IR Cochin

Tennis Elbow Embolization

Interventional Radiology · Cochin University Hospital AP-HP · Paris

🦾 Elbow · Tennis Elbow

Transcatheter Embolization for Lateral Epicondylitis (Tennis Elbow)

Alternative to repeated injections · Day case · No surgery · 70–80% improvement rate

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.

Tennis elbow embolization at a glance — At a glance

In chronic lateral epicondylitis, abnormal blood vessels sustain inflammation and pain. Embolization blocks these micro-vessels, without surgery.

Criterion Data
IndicationPain persisting beyond 6 months despite rest, physiotherapy and injections
Anaesthesia / stayLocal — day case
Does not preclude surgery laterTendon structure unaffected
CostCovered by French national health insurance at Cochin AP-HP — no out-of-pocket fees

Data validated by the team of Prof. Anthony Dohan, Department of Interventional Radiology, Cochin Hospital AP-HP, Université Paris Cité.

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

1

Pre-procedure workup: Doppler ultrasound of the elbow confirming neovascularisation, standard blood tests, stop anti-inflammatory drugs 5 days before.

2

Day case: arrive in the morning, leave the same day. Local anaesthesia at the wrist or elbow puncture site.

3

Selective arteriography under fluoroscopic guidance: hypersective catheterisation of the anterior radial recurrent artery branches feeding the pathological area.

4

Embolization: injection of calibrated microspheres into the pathological neovessels. Arteriographic control confirming occlusion.

5

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

70–80%
significant improvement at 1 year
<5%
major complications
Day case
no hospital admission

Patient Information Sheet

📄

Tennis Elbow Embolization — Patient Information

Download before your consultation.

📥 Download (PDF)

✅ Covered by French National Health Insurance (Assurance Maladie) · No extra fees · Cochin University Hospital AP-HP

Frequently asked questions

In chronic lateral epicondylitis, abnormal new blood vessels develop and sustain inflammation and pain. Embolization blocks these micro-vessels through a catheter, under local anaesthesia, as a day case.
Patients with tennis elbow pain persisting beyond 6 months despite rest, physiotherapy and injections, who want to avoid surgery.
Most treated patients report meaningful pain reduction within weeks to a few months. It targets the pain mechanism rather than the tendon structure itself.
No. Embolization does not alter the tendon or the joint, so surgery remains entirely possible afterwards if needed.
Yes. At Cochin AP-HP (a French public hospital), this procedure is covered by national health insurance with no out-of-pocket fees. Contact ri.cch@aphp.fr or +33 1 58 41 46 12.

Why this page is trustworthy

Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.

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