528 - 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

Poster Presenter(s)

Wali Badar, MD

Resident physician
University of Illinois at Chicago, United States

Author/Co-author(s)

Qian Yu, MD (he/him/his)

Resident
University of Chicago, United States
LA

Layth Alkhani, BS

Research Fellow
Joint & Vascular Institute, United States
FA

Faisal Al-Qawasmi, BS

Medical Student
UI Peoria, United States
Ajay Varadhan, BS

Northwestern Interventional Radiology Research Fellow and Medical Student
Northwestern University Feinberg School of Medicine, Chicago, IL, United States
AK

Abdul Khan, MD

Resident Physician
University of Arizona, United States
MP

Mikin Patel, MD

Assistant Professor
University of Chicago, United States
Osman Ahmed, MD, FSIR

Professor of Radiology
University of Utah, United States

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.