About Genicular Artery Embolization

Genicular artery embolization (GAE), or embolization of the knee, is a newer, minimally-invasive  procedure to reduce knee pain for patients with osteoarthritis (OA), by reducing the blood flow to the lining of the knee, known as the synovium. It is performed by an appropriately trained surgeon or interventionist who is a specialist physician that uses X-rays and other imaging modalities to see in the body and treat diseases without surgery, and has specific expertise pertaining to the vascular system and blood vessels of the body.

How Does GAE Work?

gae-embolizationGAE blocks the blood flow to the lining of the knee, known as synovium that are inflamed or otherwise scarred in arthritis.  By blocking these arteries, a reduction in the amount of inflammation associated with arthritis occurs, a process that can help or eliminate the associated knee pain.

Initial trials show this technique holds tremendous promise for patients with debilitating knee pain who are not ready or willing to undergo knee replacement surgery, or may be poor candidates for traditional knee replacement.  While it may not treat the underlying cartilage destruction, evidence so far shows that it is an effective way to manage the symptoms associated with arthritis, specifically of the knee and in some cases in the shoulder that does not carry with it the risks and downtime associated with traditional surgery. In addition unlike traditional surgery, physical therapy is typically not necessary.

Who is a Candidate for Genicular Artery Embolization?

GAE is a non-surgical treatment alternative for patients with knee pain due to osteoarthritis who have failed conservative therapy, such as anti-inflammatory medications or knee injections, and who do not wish to undergo or are ineligible or poor candidates for knee replacement surgery.

The following conditions make for a good candidate for GAE:

  1. Age: 40-80 years
  2. Moderate to severe knee pain
  3. Osteoarthritis based on x-ray, but without severe bony deformity/sclerosis
  4. Local knee tenderness
  5. Resistant/failed medical/conservative treatment (pain medication/PT/joint injections)

The following conditions may disqualify a patient as a candidate for GAE:

  1. Current or previous history of cigarette smoking
  2. Severe peripheral arterial disease
  3. Advanced arthritis based on x-ray
  4. Infection or malignancy
  5. Severe instability of the knee joint

Genicular Artery Embolization Treatment

GAE is performed with moderate ‘twilight’ sedation as an outpatient procedure, meaning the patient will go home after the procedure.  The procedure generally takes one to two hours.  Your surgeon will insert a small catheter (a thin hollow tube) into a tiny artery at the patient’s wrist and, with the use of X-rays, guide the catheter to the arteries supplying the lining of the knee.  Tiny particles are then injected through the catheter into these arteries, reducing the blood supply.  This in turn reduces the inflammation associated with osteoarthritis, which alleviates the pain.Genicular-Artery-Embolization

Risks Associated with GAE

In general, with any medical procedure, there is always a risk of bleeding, damage to other structures, and infection, however these risks are in general much lower than traditional surgery.  Risks specific to embolization include unintentional damage to blood vessels, a very low risk of “non-target” embolization (embolizing something that was not meant to be embolized).  These situations are extremely rare, and we go through a systematic series of checks to minimize the occurrence during every case.  They are possible, although very unlikely.

Aftercare and Recovery

Patients may return home the same day of surgery in most cases. Typically, relief begins to occur in two weeks, as the inflammation in the lining of the knee is reduced, relieving the knee pain associated with osteoarthritis. Some patients have reported pain relief immediately post op, however this is not the normal scenario.

What Makes NYC Surgical Associates’ Genicular Artery Embolization Treatment Unique

  1. Most centers performing GAE choose vascular access via the femoral artery, which in most patients is a much easier approach. NYC Surgical Associates does not use this approach because, though rare, if inadvertent damage to the femoral artery occurs, hemorrhagic bleeding or limb loss can occur.
  2. Typically, NYC Surgical Associates performs GAE on an outpatient basis, which allows patients to return home with minimal pain on postoperative day number one. This is unlike the inpatient hospital workflow where patients must stay for one to three days.
  3. A single, predictable bill for all services provided to allow for proper financial planning.
  4. A multidisciplinary surgical staff that works together daily.

GAE Alternatives

Genicular Artery Embolization is not the only treatment available for arthritis pain. In general, 3 options exist for pain due to arthritis:

  1. Medication
  2. Short-acting injectable medications
  3. Procedures that last longer
  4. Traditional surgery

A discussion of with your surgeon will help you decide if GAE is best for you.

Genicular Artery Embolization Cost

NYC Surgical Associates is committed to helping our patients receive the best care possible. That journey always begins with a medical consultation.

Genicular artery embolization consultations enable our doctors to better understand each patient’s knee pain and osteoarthritis,  and determine the best treatment.

Prior to booking a GAE consultation with NYC Surgical Associates, our team will collect your insurance information to determine if our providers accept your specific insurance plan.

If we do not accept your medical insurance, we will inform you of any out of pocket costs associated with a knee pain consultation and help you weigh your options. Either way, a doctor must see you before we can tell you what treatment for your condition will entail, from both a medical and cost standpoint.