Musculoskeletal Interventions: A Review on Genicular Artery Embolization

Abstract

Symptomatic knee pain is one of the most common joint diseases that affects millions of people worldwide. The treatment for knee pain secondary to osteoarthritis (OA) begins with conservative therapy and progresses to surgical intervention when conservative therapy fails. Genicular artery embolization (GAE) offers an alternative option for patients who are poor surgical candidates. Multiple studies have been conducted worldwide demonstrating the safety and efficacy of GAE in patients with mild to moderate OA. The purpose of this article is to describe the current literature on GAE and highlight the latest findings from a randomized controlled trial comparing GAE versus sham embolization.

Keywords

musculoskeletal intervention - osteoarthritis - genicular artery embolization - interventional radiology

Disclosures

• S.B. is a consultant for Boston Scientific, Varian Medical Systems, Medtronic, Embolx, IMBiotechnologies, and Phillips Medical System.

• A.I. is a consultant for Terumo, ABK Biomedical, and CrannMed.

• No other disclosures or conflicts of interest.

Publikationsverlauf

Artikel online veröffentlicht:
24. November 2021

• References

• 1 Bagla S, Rholl KS, van Breda A, Sterling KM, van Breda A. Geniculate artery embolization in the management of spontaneous recurrent hemarthrosis of the knee: case series. J Vasc Interv Radiol 2013; 24 (03) 439-442
• 2 Yoo JH, Oh HC, Park SH, Lee S, Lee Y, Kim SH. Treatment of recurrent hemarthrosis after total knee arthroplasty. Knee Surg Relat Res 2018; 30 (02) 147-152
• 3 Luyckx EGR, Mondelaers AMP, van der Zijden T, Voormolen MHJ, Van den Bergh FRA, d'Archambeau OC. Geniculate artery embolization in patients with recurrent hemarthrosis after knee arthroplasty: a retrospective study. J Arthroplasty 2020; 35 (02) 550-556
• 4 van Baardewijk LJ, Hoogeveen YL, van der Geest ICM, Schultze Kool LJ. Embolization of the geniculate arteries is an effective treatment of recurrent hemarthrosis following total knee arthroplasty that can be safely repeated. J Arthroplasty 2018; 33 (04) 1177-1180.e1
• 5 Okuno Y, Korchi AM, Shinjo T, Kato S. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis. Cardiovasc Intervent Radiol 2015; 38 (02) 336-343
• 6 Okuno Y, Korchi AM, Shinjo T, Kato S, Kaneko T. Midterm clinical outcomes and MR imaging changes after transcatheter arterial embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. J Vasc Interv Radiol 2017; 28 (07) 995-1002
• 7 Lee SH, Hwang JH, Kim DH. et al. Clinical outcomes of transcatheter arterial embolisation for chronic knee pain: mild-to-moderate versus severe knee osteoarthritis. Cardiovasc Intervent Radiol 2019; 42 (11) 1530-1536
• 8 Ashraf S, Mapp PI, Walsh DA. Contributions of angiogenesis to inflammation, joint damage, and pain in a rat model of osteoarthritis. Arthritis Rheum 2011; 63 (09) 2700-2710
• 9 Bonnet CS, Walsh DA. Osteoarthritis, angiogenesis and inflammation. Rheumatology (Oxford) 2005; 44 (01) 7-16
• 10 Mapp PI, Walsh DA. Mechanisms and targets of angiogenesis and nerve growth in osteoarthritis. Nat Rev Rheumatol 2012; 8 (07) 390-398
• 11 Bagla S, Piechowiak R, Hartman T, Orlando J, Del Gaizo D, Isaacson A. Genicular artery embolization for the treatment of knee pain secondary to osteoarthritis. J Vasc Interv Radiol 2020; 31 (07) 1096-1102
• 12 Bagla S, Piechowiak R, Hartman TS. et al. Multicenter prospective, randomized, sham-controlled study of genicular artery embolization. J Vasc Interv Radiol 2020; 31 (03) S6
• 13 Kumar S, Chandrashekhara S. Feasibility, safety and efficacy of genicular artery embolization for relief of knee pain related to osteoarthritis. J Vasc Interv Radiol 2020; 31 (03) S7
• 14 Landers S, Hely R, Page R. et al. Genicular artery embolization to improve pain and function in early-stage knee osteoarthritis-24-month pilot study results. J Vasc Interv Radiol 2020; 31 (09) 1453-1458
• 15 Little MW, Gibson M, Briggs J. et al. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) using permanent microspheres: interim analysis. Cardiovasc Intervent Radiol 2021; 44 (06) 931-940
• 16 Bagla S, Piechowiak R, Sajan A, Orlando J, Canario ADH, Isaacson A. Angiographic analysis of the anatomical variants in genicular artery embolization. J Clin Intervent Radiol ISVIR 2021;
• 17 Sajan A, Bagla S, Isaacson A. Non-neoplastic disease outside the spine-genicular artery embolization and adhesive capsulitis embolization. Tech Vasc Interv Radiol 2020; 23 (04) 100702
• 18 Casadaban LC, Mandell JC, Epelboym Y. Genicular artery embolization for osteoarthritis related knee pain: a systematic review and qualitative analysis of clinical outcomes. Cardiovasc Intervent Radiol 2021; 44 (01) 1-9