Shoulder Embolization Risks and Side Effects: What Studies Show

Every medical procedure carries some risk, and it is worth knowing exactly what you are agreeing to. Shoulder embolization has a reassuring safety record in published studies so far, with mostly mild, temporary side effects. But the studies are small, and rare problems may not show up until many more people have been treated. Here is an honest look at what has been reported.

The big picture on safety

A 2026 meta-analysis in the Journal of Vascular and Interventional Radiology pooled 12 studies covering 329 treated shoulders. Researchers counted 94 adverse events. Of these, 87 were rated mild and 7 moderate. No severe events were reported under the Society of Interventional Radiology grading system. A 2026 review of 11 studies with 422 patients likewise found no major complications reported.

A 2023 systematic review of shoulder and elbow embolization found minor side effects in 27 of 143 patients (about 19%). They went away on their own or with oral pain medicine.

These numbers are encouraging, but keep two things in mind. First, the total number of patients studied is still in the hundreds, not thousands. Second, how carefully side effects are tracked varies between studies, so true rates may differ. Most of these studies also came from experienced specialty centers, and results in everyday practice could be different.

Common, mild side effects

Shoulder ache after the procedure

A temporary deep ache in the shoulder is the most common side effect. In a 2025 Taiwanese study of 25 patients, 9 (36%) had it, and it resolved within 2 weeks. In a large 2025 study of 431 patients treated in several joints, pain at the treated site lasting longer than 7 days occurred in about 6% to 22% of patients, depending on which temporary embolic agent was used, and was more common in the elbow than in other joints.

Skin color changes over the shoulder

Pink, red, or mottled patches of skin can appear when small skin branches receive some of the embolic agent. In the Taiwanese study, this occurred in 6 of 25 patients (24%). A 2021 Spanish study of 25 patients with stiff shoulders after surgery or injury saw it in 4. These patches typically fade over days to weeks.

Bruising or tenderness at the puncture site

A bruise or small collection of blood at the wrist is common after any catheter procedure. The Taiwanese study reported it in 5 of 25 patients (20%), and all cases were mild.

Less common problems

• Blocked wrist artery. A 2025 French study of 23 patients reported 1 case (4%) of radial artery thrombosis, a clot in the wrist artery used for access. The hand usually has a second blood supply, which is one reason the wrist route is commonly used.
• Leakage of medication into the forearm. In a 2024 Spanish study of 20 patients, 1 patient had the treatment medication leak into the wrist and forearm tissues, causing swelling that resolved with simple treatment.
• Skin irritation and, rarely, skin injury. A 2024 review listed skin discoloration, itching, and, rarely, skin breakdown (necrosis) as possible complications, along with artery spasm, artery blockage, or a pseudoaneurysm at the access site.
• Contrast dye reactions and kidney strain. The procedure uses iodinated contrast. People with a history of severe contrast allergy or reduced kidney function are typically excluded from clinical trials or need special precautions.

This article is part of our Embolization Guide.

Rare but serious events

Because the arteries around the shoulder connect with other important vessels, there is a theoretical risk that embolic material could travel somewhere it was not intended. This is called non-target embolization. A 2024 case report in the Journal of Vascular and Interventional Radiology described temporary loss of vision (transient cortical blindness) after embolization for frozen shoulder. The word "transient" means the vision loss did not last. Events like this appear to be very rare, but they are the reason careful mapping of the arteries before treatment matters, and the reason you should report any vision or neurological symptoms right away.

What about the embolic agent?

Different programs use different materials. Many studies, especially from Japan, Spain, and Taiwan, used imipenem/cilastatin, an antibiotic that forms temporary particles. Others used small spherical particles, gelatin particles, or an oil-based emulsion. A 2026 review noted that the use of an antibiotic as an embolic agent raises questions about antibiotic resistance that deserve more study. Ask your doctor which agent they use, why, and what their own patients typically experience afterward. A US study published in 2022 used spherical particles under an FDA investigational device exemption, which means the particles were being formally tested for this use.

How shoulder embolization risk compares with surgery

Risk is relative. In the UK FROST trial, a large 2020 randomized study of 503 people with frozen shoulder, there were 8 serious adverse events after arthroscopic capsular release and 2 after manipulation under anesthesia. Those numbers come from a different study design, so they cannot be compared head to head with embolization case series. Still, they show that every option, including surgery, carries some risk. Our page on shoulder embolization versus surgery goes into this in more depth.

Weighing risk against the cost of waiting

Choosing not to have a procedure is also a choice with consequences. Frozen shoulder often improves over time, but not always completely. In a 2008 Oxford study of 223 patients followed for an average of 4.4 years after their symptoms began, 59% had normal or near-normal shoulders, while 41% still had some symptoms. Most of those were mild, but 6% had severe pain and loss of function. People with the worst symptoms at the start tended to do worst over the long run. Your doctor can help you weigh a small procedural risk against months or years of disrupted sleep and limited use of your arm.

Lowering your risk

• Tell your doctor about all allergies, especially to contrast dye or antibiotics
• Share your full medication list, including blood thinners and diabetes medicines
• Report kidney disease, prior arm or wrist artery procedures, and pregnancy
• Follow wrist care instructions after the procedure
• Make sure you are a good candidate in the first place. See am I a candidate for frozen shoulder embolization

For a broader look at safety across joints, visit the embolization guide, or learn more about the procedure on our shoulder embolization page.

When to get help

Call 911 for sudden vision loss, double vision, slurred speech, face drooping, weakness or numbness on one side, chest pain, or trouble breathing.

Call the office the same day if your hand turns cold, pale, blue, or numb, if the wrist keeps bleeding through pressure, if a skin patch on the shoulder darkens, blisters, or opens, or if you have a fever or spreading redness.

Frequently Asked Questions

Is shoulder embolization safe?

In published studies, side effects have mostly been mild and temporary, and no severe events were reported in a 2026 meta-analysis of 329 shoulders. The total number of patients studied is still small, so rare risks are not fully known.

What is the most common side effect?

A temporary ache in the shoulder for days up to about 2 weeks. Pink or red skin patches over the shoulder and wrist bruising are also common and usually fade on their own.

Can shoulder embolization damage the shoulder?

Embolization targets small abnormal vessels and uses mostly temporary agents. Rarely, nearby skin can be affected. Serious tissue damage has not been a pattern in published studies, but it is a theoretical risk your doctor should discuss.

Will embolization affect a future shoulder surgery?

Published shoulder studies have not reported that embolization prevents later surgery, but long-term data are limited. Ask your surgeon and interventional doctor to coordinate if surgery is still on the table.

Keep Reading

• Shoulder Embolization in Manhattan
• Shoulder Embolization vs. Cortisone Injections and Hydrodilatation
• Shoulder Embolization vs. Physical Therapy: Competitors or Partners?
• Shoulder Embolization vs. Surgery: MUA and Capsular Release Compared
• Frozen Shoulder: Causes, Symptoms, and Stages Explained
• Frozen Shoulder Embolization: Am I a Candidate?
• Embolization Guide: knee, heel, shoulder, elbow and hip

Sources

1. Allaw et al., J Vasc Interv Radiol, 2026 — systematic review and meta-analysis of embolization for adhesive capsulitis (12 studies, 329 shoulders)
2. Leung et al., Skeletal Radiol, 2026 — adhesive capsulitis embolization: a narrative review
3. Aly et al., J Med Imaging Radiat Oncol, 2023 — systematic review of embolization for shoulder and elbow pain
4. Liang et al., Korean J Radiol, 2025 — clinical and MRI outcomes of embolization for adhesive capsulitis (25 patients)
5. van Zadelhoff et al., J Vasc Interv Radiol, 2025 — safety of three temporary embolic agents in joint embolization (431 patients)
6. Fernández-Martínez et al., J Vasc Interv Radiol, 2021 — embolization for secondary stiff shoulder (25 patients)
7. Sapoval et al., Cardiovasc Intervent Radiol, 2025 — shoulder embolization with an ethiodized oil emulsion (23 patients)
8. Lanciego et al., J Vasc Interv Radiol, 2024 — midterm outcomes of embolization for adhesive capsulitis (20 patients)
9. Karns, Spartan Med Res J, 2024 — adhesive capsulitis embolization: a technique for the future
10. Liang et al., J Vasc Interv Radiol, 2024 — transient cortical blindness after shoulder embolization (case report)
11. Ubaldi et al., Front Radiol, 2026 — transarterial embolization for chronic shoulder pain: clinical evidence review
12. Bagla et al., J Vasc Interv Radiol, 2022 — US investigational device study of adhesive capsulitis embolization (20 patients)
13. Rangan et al., Lancet, 2020 — UK FROST randomized trial: MUA vs capsular release vs early physiotherapy (503 patients)
14. Hand et al., J Shoulder Elbow Surg, 2008 — long-term outcome of frozen shoulder (223 patients)

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with joint or tendon pain that hasn’t improved? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether embolization is right for you. Call (212) 362-3470 or request an appointment online.