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SIR 2026

Traditional Poster

Embolization

Session: Traditional Poster Presentations

29 - Comparative Short and Mid Term Performance of 200 µm Polyethylene Glycol Microspheres vs Ethiodized Oil Emulsion for Genicular Artery Embolization in Symptomatic Knee Osteoarthritis

Monday, April 13, 2026
12:10 PM - 1:10 PM ET
Location: Poster Hall (800 level)
Purpose: Comparative outcomes related to embolic selection for genicular artery embolization (GAE) remain poorly defined. This study investigated six- month outcomes of GAE for permanent microspheres vs temporary ethiodized oil emulsion in patients with medically refractory symptomatic knee osteoarthritis (KOA).

Materials and Methods: Sixty-seven consecutive patients (age:65.2±15.1, BMI:35.1±9.8, 57 females) underwent GAE from 9/2021-3/2025 using 200-micron microspheres (Hydropearl®, n=42, 47.7%) or an emulsion of ethiodized oil and ioversol contrast in a 3:1 ratio (Geurbet®, n=46, 52.3%). Clinical outcomes were assessed with the WOMAC Pain sub-score at baseline, one-, three-month, and six-months post-GAE visits. A 20% reduction in the WOMAC Pain score was considered clinically significant {1}. Adverse events (AE) were reported by SIR technical standard reporting guidelines. Univariate analysis was performed for treatment outcomes and embolic selection using Fisher and t-tests.

Results: 88 knees treated with KOA severity: KL3: n=38 (43.2%) & KL4: n=33 (37.5%). Pain sub-scale score decreased by 34.3% (p< 0.001*), 30.4% (p< 0.001*), and 29.9% (p< 0.001*) at 1-, 3-, and 6-months respectively. There was a 67.1% (57/85) one-, 58.7% (44/75) three-, and 60% (30/50) six-month categorical response rate. No association was observed between embolic selection and categorical response (P=0.171-0.816). All AEs were self-limiting at 20.5% (18/88). AEs included: skin changes without ulceration (n=16, 18.2%), knee swelling requiring prednisone (n=5, 5.7%), and access site hematoma (n=2, 2.3%). A lower adverse event rate was observed with lipiodol emulsion compared to microspheres (10.9% vs 31.0%, p=0.033*).

Conclusion: GAE shows positive short and mid-term outcomes up to six-months post treatment for KOA. Lipiodol emulsion may offer better safety profile over microspheres.