94 - Safety and Efficacy of Genicular Artery Embolization with Calibrated Microspheres for Osteoarthritis Knee Pain: Insights from an Early Academic Practice

Genicular artery embolization (GAE) is an emerging technique for managing knee pain due to osteoarthritis (OA). This study evaluates the safety and efficacy of GAE on pain reduction related to knee OA using calibrated 250-μm microspheres in a real-world collaborative clinical practice. Unique aspects of the analysis include that all grades of OA were included, and treatment was performed with moderate-sized microspheres with intent to avoid the most common adverse events seen in prior studies.

Materials and Methods:

This retrospective study analyzed data from 20 GAE procedures performed on 16 patients with OA without prior total knee arthroplasty. Patient demographic data, procedural details, Visual Analog Scale (VAS) pain scores (pre- and post-procedure), fluoroscopy times, radiation doses, and adverse events were evaluated. Statistical analyses included descriptive statistics, paired t-tests to compare pre- and post-procedure VAS scores, and 95% confidence interval (CI) calculations.

Results:

The patients had a mean age of 54.4 years (SD=10.9) and a mean BMI of 40.3 kg/m² (SD=5.3). Eighty-seven percent (N=14) of patients were female. The mean VAS pain score prior to the procedure was 8.1, which decreased significantly to 4.0 post-procedure, with an average reduction of 4.1 points (p < 0.01). The mean number of arteries embolized per procedure is approximately 1.55 (range between 1-3). The average fluoroscopy time was 29.2 minutes (SD=20), and the mean radiation dose was 484.3 mGy (SD= 437.4). Only one procedure (5%) resulted in minor complications, which included superficial vein thrombosis that resolved without intervention.

Conclusion:

GAE using calibrated 250-μm microspheres significantly reduces knee pain in patients with a wide range of OA. Frequent skin discoloration seen in prior studies is not demonstrated in the current analysis and may be due to the use of moderate-sized microspheres. These results provide strong evidence supporting GAE as a valuable tool for managing osteoarthritic knee pain, potentially reducing the need for more invasive interventions. Additionally, this study highlights the potential of GAE with calibrated 250-μm microspheres to offer significant pain relief and enhance patient quality of life, particularly for patients who are not surgical candidates or prefer to avoid surgery. These findings warrant further study with larger cohorts and more extended follow-up periods to better understand the benefits and limitations of GAE using calibrated moderate-sized particles in managing osteoarthritic knee pain.