Minimally Invasive Genicular Artery Embolization for Effective Knee Pain Relief

Vascular Centers of Texas

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What is GAE?

Genicular artery embolization is a minimally-invasive treatment for knee pain caused by osteoarthritis. This innovative procedure is performed by an Interventional Radiologist in an outpatient setting. By placing a small access point in the groin or wrist, we’re able to insert a small catheter into the Genicular Artery. The catheter allows us to identify abnormal vessels that have grown that cause inflammation and pain in the knee joint. Once the vessels are identified, we inject biocompatible embolization spheres into the affected blood vessels that feed the inflammation and pain. By blocking ONLY these abnormal vessels, patients are experiencing a significant reduction in inflammation and pain and are able to resume normal daily activities.

Treatment for

Osteoarthritis Knee Pain

Most people are familiar with arthritis, but don’t have a complete understanding of the condition. Arthritis is a way of describing many conditions involving inflammation that causes joint pain. Osteoarthritis is the most common form of arthritis and is caused by the cartilage of the joint being worn down over time or trauma. It is most common in the knees and cannot be reversed. However, there are some treatments available to help improve joint function or reduce pain. Over 32 million adults in the US have osteoarthritis, also known as degenerative joint disease. The risk of developing osteoarthritis increases with overuse of the joint, injury to the joint, age, and obesity. Women are more likely to develop osteoarthritis and genetics can indicate increased risk for osteoarthritis.

Find out if you are a candidate

Initial (left) and final (right) angiograms of the knee after embolization. A circular marker was placed at the site of pain. The reduced blood flow at the site of pain after embolization reduced inflammation of the knees.

How is GAE Performed?

GAE is performed with the need of general anesthesia and having to put the patient to in sleep. Instead, it is performed with moderate ‘twilight’ sedation as an outpatient procedure just like having a colonoscopy or breast needle biopsy type procedure. This means that the patient will go home immediately after the procedure without a long recovery from surgery. The entire procedure usually only takes one to two hours to perform and is done without making any surgical incisions. Instead, it is performed via a small IV started in the thigh. This involves inserting a small catheter (a thin hollow tube) into the artery of the patient’s upper thigh and with the use of X-ray guidance, the catheter is placed into the arteries supplying the lining of the knee. An angiogram is then performed that shows where the inflammation is happening. Tiny particles are then injected through the catheter into these small arteries thereby reducing the blood supply to the synovium (knee lining). This then reduces the inflammation associated with arthritis, which eliminates the pain.

What to Expect After the GAE Procedure?

All patients go home the same day after a few hours in the recovery area. Pain relief usually begins to be noticed in two weeks, as the inflammation in the lining of the knee subsides and goes away thereby relieving the knee pain associated with the arthritis.

How do you know if you are a Candidate for GAE?

This is a good option for patients who have pain and have failed physical therapy and for those whose pain medications are no longer working. Treatments such as anti-inflammatory medications or knee injections usually only work for so long in controlling pain. GAE is also indicated in anyone who does not wish to undergo or is ineligible for knee replacement surgery. The following are some guidelines for those thinking of GAE
  • Age: 45-80 years
  • Moderate to severe pain
  • Osteoarthritis based on x-ray findings
  • Knee tenderness that can be localized
  • Failed conservative treatment (NSAIDs/PT/joint injection)

Benefits of GAE for Knee Pain

  1. No incisions so no chance of having a knee infection after the procedure
  2. Outpatient procedure, back home, and at work the next day
  3. Very little to no risk for anesthesia-related complications such as heart attacks and strokes during the procedure
  4. Diabetics with high A1C levels can behave the procedure done

Recovery from a GAE Procedure

Patients go home the same day as the procedure after a few hours of recovery time. You may have a small bruise with some mild tenderness in the groin where the IV is started. Taking it easy the day of the procedure is recommended, however, by the following day we recommend returning to light activity with no heavy exercise or lifting greater than 15lbs. One week after the procedure the patient may return to heavy activity and exercise. Patients usually notice a significant improvement in their pain 1-2 weeks after the procedure as the inflammation in the joint goes away.

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