SIR 2024
Arterial Interventions and Peripheral Arterial Disease (PAD)
Tommy Pan, MD (he/him/his)
Interventional Radiology Research Intern
New York University Langone Health
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David Swilling, BS
Research Intern
NYU Grossman School of Medicine
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Tarub S. Mabud, MD
Resident Physician
New York University Grossman School of Medicine
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Mukundan Attur, PhD
Associate Professor
NYU Grossman School of Medicine
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Jonathan Samuels, MD
Associate Professor of Medicine
NYU Grossman School of Medicine
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Shu Liu, MD
Clinical Assistant Professor
NYU Grossman School of Medicine
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Elizabeth Morris, MD
Clinical Assistant Professor
Department of Radiology at NYU Grossman School of Medicine
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William Macaulay, MD
Professor of Orthopaedic Surgery
NYU Grossman School of Medicine
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Bedros Taslakian, MD, FCIRSE (he/him/his)
Director of VIR Research Program; Director of Clinical Research Integration
NYU Langone Health
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This abstract aims to describe the current diagnostic criteria for knee osteoarthritis (OA) and discuss the role of available disease-specific biomarkers in the diagnosis and screening of patients with knee OA. Additionally, prognostic biomarkers can aid in understanding the effect and mechanism of available treatment options and evaluating treatment response. An understanding of disease-specific biomarkers is essential, particularly to characterize the therapeutic role of interventions targeting disease pathophysiology, such as genicular artery embolization (GAE).
Background:
Knee osteoarthritis (OA) is a leading cause of disability, with an estimated 25 million cases of
radiologically confirmed, symptomatic knee osteoarthritis in the United States {1}. Traditionally considered a wear and tear disease, knee OA is now considered a biomechanical whole-organ disease with an inflammatory component {2,3}. Biomarkers are defined as objective indicators of normal pathophysiologic processes and may evaluate the response to therapeutic interventions such as genicular artery embolization. Recent studies advocate that certain biomarkers may aid in the diagnosis, prognostication, and evaluation of treatment response in patients with knee OA {4}.
Clinical Findings/Procedure Details:
OA is a disease of not only wear and tear, but a disease characterized by inflammation, angiogenesis, and new nerve formations. Hindering inflammation, angiogenesis, and nerve growth with genicular artery embolization may have therapeutic potential in the treatment of knee OA beyond pain management. One biomarker of particular interest is nerve growth factor (NGF), which has been linked to pain development and cartilage degeneration {5}. In a prospective, single-arm clinical trial of patients undergoing GAE for symptomatic knee OA who failed conservative therapy for greater than 3 months, there was a significant decrease in both NGF levels and pain scores at 12 months post-GAE{6}. Another biomarker of interest is vascular endothelial growth factor (VEGF) which has been associated with the structural changes of OA. Taslakian et al. reported a decrease in VEGF in all 5 patients at 12 months post-GAE which approached statistical significance in a prospective clinical trial {6}.
Conclusion and/or Teaching Points:
Awareness of OA-specific biomarkers among interventional radiologists and their inclusion in prospective clinical trials may help clarify the role of GAE as a potential disease-modifying intervention. Demonstration of a disease-modifying effect of GAE may expand the indications for this novel procedure.