Genicular Artery Embolization (GAE): FAQs
What is GAE?
Genicular artery embolization (GAE) is a cutting-edge, minimally invasive procedure that targets the source of inflammation, providing lasting pain relief and improved mobility, particularly for osteoarthritis-related conditions.
Take control of your joint health with this proven treatment—no surgery necessary.
Understanding GAE
Genicular artery embolization (GAE)—sometimes referred to as geniculate artery embolization—is a minimally invasive treatment aimed at alleviating osteoarthritis-related knee pain. It targets abnormal blood vessels in the knee, which are believed to contribute to inflammation and discomfort
Ideal Candidates
Who is the best candidate for GAE?
A GAE knee procedure is ideal for patients with mild knee arthritis or knee pain secondary to inflammation, as well as for those who are not candidates for knee surgery or who prefer to avoid surgery. It is recommended for individuals who have not found adequate relief from physical therapy, medications, or injections.
Can GAE be used for severe knee pain?
Yes, GAE for knee pain can be effective in severe cases, including osteoarthritis-related knee pain. While it is often recommended for patients with mild to moderate joint damage, it can also benefit those looking to delay or avoid knee replacement surgery. In advanced stages of osteoarthritis, the effectiveness of GAE may vary depending on the extent of joint degeneration.
Are there age limits for GAE treatment?
There are no strict age limits, but the procedure is typically recommended for adults experiencing chronic knee pain.
Can GAE be used for other knee conditions beyond arthritis?
Yes, a genicular artery embolization (GAE) procedure can also address other inflammatory knee conditions, such as synovitis, post-traumatic arthritis, and overuse injuries, although its primary use is for arthritis-related pain.
Is GAE suitable for patients who cannot undergo surgery?
Yes, knee embolization is an excellent alternative for patients who:
1. Cannot undergo surgery due to health or age concerns, such as problems controlling their diabetes. High sugar levels increase the risk for infections.
2. Prefer a minimally invasive option over traditional surgical procedures
Procedure Details
How is genicular artery embolization performed?
During a GAE surgery, a small needle puncture is made in the groin (femoral artery) or wrist (radial artery) to access the blood vessels. Using advanced imaging technology, a catheter is guided to the genicular arteries, where tiny FDA-approved embolic particles, typically made of materials like polyvinyl alcohol (PVA) or microspheres, are injected to block blood flow to inflamed areas.
How long does the GAE procedure take?
GAE typically takes 1–2 hours to complete.
What technology and imaging are used during GAE?
Advanced imaging technologies are essential to the success of a GAE procedure:
More Procedure Details
Fluoroscopy
This real-time X-ray imaging method allows interventional radiologists to visualize the catheter’s path, navigate through blood vessels, and monitor the precise placement of embolic particles in the genicular arteries.
Contrast agents
These are used with fluoroscopy to highlight blood vessels and ensure the correct placement of embolic particles. They also help provide real-time visualization of blood flow during the procedure.
Additional imaging technologies
In some cases, additional imaging techniques, such as ultrasound or CT scans, may be used to assist in locating blood vessels and ensuring the accurate placement of the embolic particles.
Does the patient need anesthesia for the procedure?
Yes, GAE is performed using local anesthesia to numb the access site (groin or wrist) and light sedation to keep the patient relaxed and comfortable. The patient remains awake, able to communicate with the medical team, and experiences little discomfort during the procedure.
This approach minimizes risks, promotes faster recovery, and reduces the likelihood of complications. Most patients feel only slight pressure or mild sensations during the procedure, with the medical team ensuring comfort at every step.
What materials are used during the embolization process?
The embolization process uses tiny particles designed to selectively block abnormal blood flow. Common materials include polyvinyl alcohol (PVA) particles, gelatin sponge particles, microspheres (made from hydrogel or acrylic), and occasionally, metallic coils.
These materials are FDA-approved, biocompatible, and come in various sizes, typically ranging from 100 to 500 microns, to ensure precise targeting of small blood vessels.
Materials
PVA particles
A widely used synthetic polymer known for its consistent size and shape, making it ideal for effectively blocking small vessels.
Microspheres
Engineered for controlled embolization, offering precise sizing, and made from hydrogel or acrylic.
Gelatin sponge particles
Biodegradable, providing temporary blockage as they break down over time.
Find out if you are a candidate
Preparation for GAE
What tests or evaluations are needed before GAE?
Before GAE, patients typically undergo the following imaging tests:
- MRI to evaluate joint inflammation, soft tissue conditions, and overall knee health
- X-ray to assess bone structure, joint damage, and arthritis progression
- CT angiography to map blood vessel anatomy for precise embolization planning
- Doppler ultrasound to examine blood flow and vascular condition
A consultation with a vascular and interventional radiology specialist is also required. This includes:
- Reviewing medical history and current medications
- Conducting a physical examination and blood tests
- Screening for health conditions and contraindications
- Evaluating pain levels and prior treatments to confirm eligibility for the procedure
How should I prepare for the GAE procedure?
Follow instructions from your doctor, which may include stopping certain medications and fasting for a few hours.
Can I eat, drink, or take medications before GAE?
You may need to avoid eating and drinking for a specific period before the procedure. Some medications may need to be adjusted. It’s important to follow the specific fasting instructions provided by your healthcare team, as they may vary slightly depending on your individual case and the facility’s protocols.
How do I know if I’m eligible for GAE?
Your doctor will review your medical history, imaging results, and current symptoms to determine your eligibility.
After the Procedure
After GAE, patients typically remain in the medical facility for 2-4 hours for observation to monitor for immediate complications. Mild soreness around the incision site and potential knee discomfort are common. Most patients go home the same day, with pain medications prescribed if needed to manage mild to moderate discomfort.
Outcomes and Effectiveness
Studies indicate that GAE is an effective treatment for knee pain, particularly in osteoarthritis-related cases. Many patients experience significant pain relief, depending on factors such as the severity of the condition and patient characteristics. Clinical evidence highlights improvements in mobility, reduced reliance on pain medications, and enhanced quality of life for most patients.
Patients with mild to moderate osteoarthritis tend to benefit the most, with 75–85% reporting substantial reductions in pain after the procedure. These patients often enjoy sustained relief lasting 6–12 months or longer.
Risks and Medical Considerations
Are there any risks or side effects associated with GAE?
GAE is generally safe but carries minor risks, such as bruising, mild infection, or temporary discomfort. In rare cases, patients may experience mild swelling or skin discoloration near the incision site, which typically resolves on its own.
Can I undergo GAE if I have other health conditions?
Patients with certain health conditions may still be eligible for GAE, as the procedure is minimally invasive and generally well-tolerated. Your doctor will assess your overall health, medical history, and any underlying conditions to determine if the procedure is a safe and effective option for you.
Is GAE covered by insurance?
Most insurance plans cover GAE, but coverage can vary depending on your provider and the specific terms of your policy. Check with your insurance company to confirm whether the procedure is covered and what documentation may be required for approval.
Who performs the GAE procedure?
GAE is performed by an interventional radiologist, a medical specialist trained in minimally invasive procedures guided by advanced imaging technology. These specialists have expertise in navigating blood vessels and precisely targeting areas of inflammation, ensuring that the procedure is both safe and effective.