716 - Musculoskeletal Embolization: Review of Existing and Emerging Indications

Monday, April 13, 2026

5:21 PM - 5:27 PM ET

Abstract Presenter(s)

BA

Bader Abou Shaar, MD

Interventional Radiology Resident
Cleveland Clinic Foundation, United States

Author/Co-author(s)

YO

Yuji Okuno, MD, PhD

Chief Director
Okuno Clinic, Japan
JG

Jafar Golzarian, MD

University of Minnesota, United States
YU

Yuji Umeda, MD

Orthopedic surgeon
Cleveland Clinic, United States
YL

Yu An Lin, DO

Radiology resident
Cleveland Clinic, United States
EC

Edwin F. Chou, MD

Interventional radiology fellow
Cleveland Clinic, United States
AL

Abraham Levitin, MD

Staff
The Cleveland Clinic Foundation, United States
Justin J. Guan, MD

Associate Staff Physician
Cleveland Clinic, United States

Learning Objectives:

List all major musculoskeletal regions for which arterial embolization has been applied, including knee, shoulder, elbow, wrist, back, hand and ankle

For each musculoskeletal region above, discuss both common/more established indications, as well as newer/more investigational indications for embolization

Summarize current data on clinical outcomes and complications, patient selection, and technical considerations, particularly for the more established indications above

Understand areas of active research (need for placebo studies, long-term retrospective data, and prospective data) and future directions for MSK embolization

Background: Musculoskeletal (MSK) embolization is a relatively new but promising field of IR, offering minimally invasive options for patients with chronic pain syndromes, degenerative and inflammatory joint disease, refractory musculoskeletal pain, and tendinopathies. Initially reported in genicular artery embolization for hemarthrosis and osteoarthritis, MSK embolization has since been utilized to treat pathologies involving the shoulder, hip, elbow, wrist, back, hand and ankle. This exhibit aims to present the existing and emerging indications for the various musculoskeletal regions, with a focus on patient selection, technical considerations, current data on clinical outcomes, complications, and future directions for research.

Clinical Findings/Procedure Details:

Pathophysiology underlying effectiveness of MSK Embolization: Neovascularity causing inflammation/pain

Indications by MSK region – each with discussions of patient selection, clinical outcomes, complications, technical considerations; with angiographic correlation:

Knee – hemarthrosis, osteoarthritis

Shoulder – adhesive capsulitis

Elbow - epicondylitis

Wrist – tenosynovitis, overuse injuries, osteoarthritis

Back – cervical myalgia, chronic lower back pain

Hips – osteoarthritis, greater trochanteric pain syndrome

Hands/Feet – osteoarthritis, plantar fasciitis, achilles tendinitis

III. Future Directions

Developing Indications

Need for placebo, prospective, and long-term retrospective data:

Knee – GENESIS I/II, Bagla et al. GAE vs Sham, GENI Trial

Shoulder – AES for Shoulder Pain

Elbow – EAE safety/efficacy Trial

Conclusion and/or Teaching Points: MSK embolization is a promising field of IR, with growing evidence supporting its use for a variety of joint pathologies. While long-term, prospective, and controlled data is needed to further establish MSK embolization, this field has the potential to become a standard, minimally-invasive treatment option for patients with joint pathologies.