What is the difference between C-TAME and s-TAME? A complete comparison of catheter-based and ultrasound-guided transcatheter arterial microembolization

Both C-TAME and s-TAME belong to TAME (Transcatheter Arterial Micro-Embolization) therapy. The treatment goal for both is identical, which is targeting potential abnormal microvessels at the site of chronic pain. The biggest difference between them lies in the treatment method and the guidance tools used: C-TAME is performed using a catheter paired with angiography equipment, making it suitable for deeper areas or sites requiring highly precise localization; s-TAME utilizes ultrasound-guided fine needle injection, making it suitable for superficial pain areas that can be localized via ultrasound. They are not old vs. new versions of each other; instead, the selection is made based on pain location, depth, and evaluation results.

Chronic pain that has persisted repeatedly for more than three months, and where other treatments have shown limited effectiveness, is the most suitable for evaluation.

What is TAME?

TAME (Transcatheter Arterial Micro-Embolization) is a minimally invasive treatment targeting the mechanism of chronic pain. When pain persists long-term, abnormally proliferating microvessels, along with related neural changes, may appear at the pain site—factors that can be involved in the creation and maintenance of chronic pain. The method of TAME involves using embolic materials to selectively treat pain-related abnormal microvessels to reduce the impact of these vessel-related mechanisms on pain, rather than simply suppressing the sensation of pain.

TAME technology was developed and promoted by Dr. Yuji Okuno of Japan, and related research has been sequentially published in international medical journals. Sunrise Clinic has successfully obtained the trademark authorization for Okuno Clinic Japan in Taiwan, providing catheter-based C-TAME and ultrasound-guided s-TAME evaluations tailored to different pain locations and medical conditions.

What is the difference between C-TAME and s-TAME? Understand it through a single table

C-TAME is accessed through a catheter and paired with angiography to confirm location, making it suitable for treating deeper areas. s-TAME relies on a fine needle guided by ultrasound, which makes the procedure simpler, but it is only suitable for superficial areas visible via ultrasound. Both are outpatient procedures performed under local anesthesia and do not require hospitalization.

The difference between the two is not a matter of "which is better," but rather a difference in the suitable areas for treatment and the required conditions. The catheter in C-TAME can reach deeper areas and confirm the embolization range under angiography. s-TAME eliminates the catheter and contrast media, making the process simpler, but it is only applicable to superficial targets visible on ultrasound.

Why does C-TAME require angiography equipment?

C-TAME requires the assistance of angiography equipment to help physicians locate the target blood vessels.

Since the microvessels associated with chronic pain are small in diameter, relying solely on 2D images may make it difficult to confirm the catheter position and the embolization range. Angiography equipment equipped with cone-beam CT functionality can provide 3D imaging information during the treatment process, assisting physicians in more precisely confirming vessel locations for selective embolization.

Sunrise Clinic is outfitted with a GE OEC 3D mobile C-arm that features cone-beam CT functionality. It conducts C-TAME evaluations and treatment procedures in its own in-house angiography operating room, saving patients from having to transfer to other medical institutions to complete the treatment.

In contrast, s-TAME uses ultrasound as a guidance tool and does not require angiography equipment; therefore, it is mainly applied to superficial pain areas that can be clearly localized with ultrasound.

Which situations are suitable for evaluating C-TAME, and which are suitable for s-TAME?

The choice between C-TAME and s-TAME primarily depends on the pain location, depth, and whether the associated blood vessels can be precisely localized and treated.

If the pain is located in a deeper area or requires the confirmation of target blood vessels via angiography, the physician may evaluate whether it is suitable for C-TAME. Examples include chronic knee pain caused by osteoarthritic knees, frozen shoulder (adhesive capsulitis of the shoulder), chronic pain around the hip joint, and repeated pain around deep joints.

If the pain location is more superficial and can be clearly localized via ultrasound, it may be suitable to evaluate for s-TAME. Examples include De Quervain's tenosynovitis (mommy's wrist), plantar fasciitis, tennis elbow, finger osteoarthritis, and chronic pain at tendon insertion points.

The actual suitability of either method must still be determined by a physician through medical consultations, physical examinations, and imaging evaluations. For some patients, evaluation might reveal that the cause of pain does not stem from mechanisms suitable for embolization treatment, and alternative treatment directions may be recommended.

Treatment Procedures and Recovery for C-TAME and s-TAME

In most cases, C-TAME is performed under local anesthesia. The physician will establish vascular access from the wrist or another suitable site, thread a microcatheter to the target vessel location, and then proceed with selective embolization. The treatment wound is usually just the size of a needle puncture. Patients can return home following a post-procedure observation period, with follow-up appointments scheduled according to the treated area and individual progress.

Under ultrasound guidance, s-TAME uses a fine needle to target the pain-related area for treatment. Since vascular access is not required, the overall process is relatively straightforward, but its scope of application depends on whether ultrasound can clearly localize the target area. The actual treatment method and recovery time must still be explained by the physician based on individual conditions.

Frequently Asked Questions

Q: Is C-TAME a surgery?
C-TAME is not a traditional open surgery, but a minimally invasive interventional therapy performed through blood vessels. The treatment establishes access via an arterial needle puncture and does not require tissue incision, and the majority of cases are performed under local anesthesia.

Q: Is the effect of s-TAME worse than that of C-TAME?
C-TAME and s-TAME address different target conditions; they are not an upgraded vs. older version relationship. If the pain location is suitable for ultrasound localization, s-TAME may be the right choice; if entering deeper vessels or more precise positioning is required, C-TAME may be necessary.

Q: Can I still undergo TAME if I have had PRP or hyaluronic acid injections before?
Yes, an evaluation can be performed. Having received injection treatments in the past does not affect your eligibility for TAME evaluation. The physician will make a judgment based on your current medical condition and imaging.

Q: How many times does TAME need to be performed?
The number of treatments varies depending on the site of pain, medical condition, and response to treatment. It cannot be generalized and requires evaluation and explanation by a physician.

Q: Where in Taipei can I get evaluated for C-TAME?
Sunrise Clinic provides C-TAME and s-TAME evaluation services. Suitability for the treatment must be determined by a physician through medical consultation, physical examination, and imaging evaluation.

Sunrise Clinic is located at 2F-1, No. 40, Sec. 2, Heping E. Rd., Da’an Dist., Taipei City. It operates strictly by appointment. If you require a chronic pain evaluation, you can book a specialized pain consultation via LINE or by calling (02) 2366-0186.