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SIR 2026

Traditional Poster

Pain Management/MSK

Session: Traditional Poster Presentations

595 - Correlation of Radiopaque Markers with Embolic Delivery Targets in Genicular Artery Embolization: A Large Academic Multicenter Analysis

Monday, April 13, 2026
12:10 PM - 1:10 PM ET
Purpose: To evaluate the utility of placing radiopaque BB skin markers at patients’ areas of maximal knee pain in order to correlate intraprocedurally with genicular artery angiographic findings during Genicular Artery Embolization (GAE) for symptomatic knee osteoarthritis.

Materials and Methods: This retrospective multicenter study from 6/1/2022-8/19/2025 includes 34 patients and 39 knees which underwent GAEs for symptomatic knee osteoarthritis. Demographic and technical data was collected including age, sex, BB marker location (medial/lateral and cranial or caudal), genicular artery branches embolized, and amount of embolic used for each branch. GAE embolization was performed by operators with over 10 years of experience who embolized in the setting of synovial hyperemia. Data was analyzed utilizing IBM SPSS Statistics version 29.0.0.0 (IBM, Armonk, New York). A paired sample t-test was performed comparing the amount of embolic that corresponded to BB marker placement versus the amount used in other areas of the knee when dividing the knee medially/laterally and cranially/caudally.

Results: 69% of the cohort was female, with a median age of 65 years, and the site of pain was most often medial (58%) and cranial 44% (Table 1). For BB markers placed on the medial or lateral aspect of the knee, the area of the BB marker received an average of 1.1mL of particle embolic material vs 0.46mL embolic material in the unmarked laterality p=0.017. For BB markers placed on the cranial or caudal aspect of the knee, the area of the marker received 1.1mL of embolic material vs 0.46 mL of embolic in the unmarked laterality p=0.022.

Conclusion: BB markers correspond well to the location and amount of embolic administered, indicating that the neovascular blush traditionally targeted during GAE correlates well with our patients’ point of maximal pain. As institutional protocols are developed nationwide, intra-operative pain point identification may prove to be an important tool in the selection of vascular territories for embolization during GAE.