Genicular Artery Embolization Overview
Genicular artery embolization (GAE) is a relatively new medical procedure that offers a novel approach to the treatment of knee osteoarthritis (OA). The procedure primarily targets the synovial arterial hypervascularity, a condition associated with OA symptoms, and aims to reduce its impact. It's an innovative treatment option for those suffering from knee OA, particularly for those who have found little relief from other conservative therapies.
Understanding GAE Procedure
GAE is an interventional procedure aimed at reducing pain symptoms associated with moderate to severe knee OA. The procedure works by embolizing, or blocking, the genicular arteries that supply blood to the knee joint. This results in a reduction in synovial arterial hypervascularity, which is typically seen in patients with OA.
The procedure involves the insertion of a catheter into the genicular arteries, through which embolic agents are delivered. These agents work to block the blood flow, reducing the hypervascularity, and consequently, the associated symptoms of OA. It's a minimally invasive procedure that can be performed under local anesthesia, and it typically takes around 1 to 2 hours to complete.
Benefits and Risks of GAE
As per a study published on NCBI, GAE has been found to be both effective and durable in reducing pain symptoms from moderate or severe knee OA that is refractory to other conservative therapy. The procedure offers several benefits, including a significant reduction in pain, improved mobility, and enhanced quality of life. It's a minimally invasive procedure with a short recovery time and has been reported to have an acceptable safety profile.
However, like any medical procedure, GAE is not without its risks. Possible complications may include infection, hematoma at the access site, allergic reaction to the contrast agent, non-target embolization, and transient ischemic attacks. However, these risks are relatively low, and serious complications are rare. Patients should discuss these potential risks with their healthcare provider to make an informed decision about undergoing the procedure.
In summary, GAE is a promising treatment option for patients with symptomatic knee OA. With its high efficacy and safety profile, it presents a viable alternative to more invasive surgical options. As research progresses and success rates continue to be evaluated, understanding the benefits and risks of GAE will become increasingly important.
Success Rates of Genicular Artery Embolization
When it comes to evaluating the effectiveness of genicular artery embolization (GAE), immediate technical success and long-term efficacy and safety are two critical factors. These aspects help us answer the question - 'what is the success rate of genicular artery embolization?'
Immediate Technical Success Rate
Immediate technical success refers to the successful completion of the GAE procedure without any procedural complications. Studies have shown impressive immediate technical success rates for GAE.
In the LipioJoint-1 trial, the immediate technical success rate of GAE was 100% [1]. Similarly, in a prospective trial of GAE for the treatment of knee osteoarthritis, technical success was achieved in 100% of the subjects [2].
A meta-analysis involving 10 groups (9 studies; 270 patients; 339 knees) found an overall GAE technical success rate of 99.7%. Furthermore, another study involving 40 subjects with moderate or severe knee osteoarthritis reported GAE was technically successful in 100% of the subjects.
These findings show that GAE is a procedure that can be successfully executed, providing a promising start to the treatment journey of patients with knee osteoarthritis.
Long-Term Efficacy and Safety
The long-term efficacy and safety of GAE is crucial in assessing its overall success. In the context of GAE, this refers to the sustained pain relief and functional improvement after the procedure, as well as the absence of any serious adverse effects.
In the aforementioned prospective trial, not only was technical success achieved in 100% of the subjects, but there were no reported neurologic or distal vascular complications [2]. This is an encouraging sign for the safety profile of GAE.
While long-term data is still being gathered, these early indicators of safety, combined with the high immediate technical success rates, make GAE a promising procedure for the treatment of knee osteoarthritis. More research is needed to further evaluate the long-term efficacy and safety of GAE, but the initial results are promising.
Research Findings on GAE
Insights from various research studies provide a comprehensive view of the effectiveness of Genicular Artery Embolization (GAE). They shed light on several key parameters like pain score reductions, WOMAC function score improvements, and the proportion of responders and adverse events.
Pain Score Reductions
One of the primary goals of GAE is to alleviate knee pain in osteoarthritis patients. In a study published by the Society of Interventional Radiology in March 2021, the average pain scores significantly decreased from eight out of ten before GAE to three out of ten within the first week of treatment, indicating a significant reduction in knee pain for patients [4].
Furthermore, at three months post-treatment, the mean Visual Analogue Scale (VAS) pain score decreased significantly from 74.4 ± 16.5 mm at baseline to 37.2 ± 26.7 mm.
WOMAC Function Score Improvement
Along with pain relief, GAE also aims to improve knee function in patients. At three months post-treatment, the mean WOMAC function score (normalized to 100) decreased significantly from 57.3 ± 17.1 at baseline to 33.5 ± 25.9.
Responders and Adverse Events
As for the proportion of responders, in the LipioJoint-1 trial, 73% of the participants (16 out of 22) were considered responders at three months, meeting the OMERACT-OARSI set of responder criteria, which included high improvement in pain, WOMAC function, or both [1].
In terms of adverse events, over two years, 5.2% of patients underwent total knee replacement and 8.3% received repeat GAE. The most common minor adverse event was transient skin discoloration, affecting 11.6% of patients.
These findings underscore the promising efficacy of GAE in managing knee pain and improving function in osteoarthritis patients, with a majority of patients responding positively to the treatment and a low rate of adverse events.
Meta-Analysis Results
The success rate of genicular artery embolization (GAE) has been evaluated in multiple studies to provide an understanding of its efficacy. In this section, we will delve into the technical success rate insights and the clinical outcomes over time.
Technical Success Rate Insights
In a systematic review and meta-analysis of 9 studies involving 270 patients and 339 knees, GAE for knee osteoarthritis (OA) pain had a technical success rate of 99.7% [3]. This impressive technical success rate is further confirmed by the LipioJoint-1 trial, which reported a 100% immediate technical success rate for GAE.
| Study |
Technical Success Rate |
| 9 Studies Meta-Analysis |
99.7% |
| LipioJoint-1 Trial |
100% |
Clinical Outcomes Over Time
Over the course of 12 months, significant improvements were noted in the weighted mean difference (WMD) in knee pain visual analog scale (VAS) score and WOMAC Total score. At 12 months, 78% of patients met the minimal clinically important difference (MCID) for VAS score, 92% met the MCID for WOMAC Total score, and 78% met the substantial clinical benefit (SCB) for WOMAC Total score [3].
Moreover, higher baseline knee pain severity was associated with greater improvements in knee pain. Over a period of 2 years, 5.2% of patients underwent total knee replacement and 8.3% received repeat GAE. Adverse events were minor, with transient skin discoloration being the most common.
A study published by the Society of Interventional Radiology in March 2021 further indicated a significant reduction in knee pain for patients with osteoarthritis. The average pain scores decreased from eight out of ten before GAE to three out of ten within the first week [4].
| Time After GAE |
VAS Score |
WOMAC Score |
Patients Meeting MCID (VAS) |
Patients Meeting MCID (WOMAC) |
| 12 Months |
-34 to -39 |
-28 to -34 |
78% |
92% |
| 2 Years |
- |
- |
- |
- |
These results strongly suggest that GAE has high technical success rates and positive long-term clinical outcomes, providing substantial relief for patients suffering from knee OA pain, and thus answering the question of 'what is the success rate of genicular artery embolization'.
Patient Trials and Outcomes
Understanding the efficiency and safety of the genicular artery embolization (GAE) procedure is enhanced by scrutinizing patient trials and outcomes. These trials provide valuable insights into the demographics of the patients, treatment success rates, and potential adverse events associated with the procedure.
Enrolment and Demographics
Over a period of 10 months, 40 subjects were enrolled in a trial to study the outcomes of the GAE procedure. The median age of the subjects was 69 years, and the median body mass index (BMI) was 29 kg/m^2. This group of people provided invaluable data on the success rate of genicular artery embolization.
Treatment Success and Adverse Events
The GAE procedure achieved a technical success rate of 100% among the subjects. There were no reported neurologic or distal vascular complications, indicative of the high success rate of genicular artery embolization [2].
However, there were some treatment-related adverse events. One subject experienced a groin hematoma requiring overnight observation. Seven subjects had self-resolving focal skin ulceration, and two subjects had an asymptomatic small bone infarct.
In terms of efficacy, the WOMAC total score and VAS pain scores decreased by 61% and 67% at 12 months, respectively. Notably, 68% of patients experienced a reduction of ≥50% in both scores, demonstrating the significant impact of GAE in reducing pain and improving patient outcomes [2].
| Treatment Outcomes |
Percentage |
| Reduction in WOMAC total score |
61% |
| Reduction in VAS pain scores |
67% |
| Patients experiencing ≥50% reduction in both scores |
68% |
Moreover, twenty-seven patients (68%) had a reduction of ≥50% in both WOMAC total and VAS pain scores at 12 months, further attesting to the effectiveness of GAE.
These findings from patient trials and outcomes support the assertion that genicular artery embolization is a potentially successful treatment for pain relief while maintaining a relatively low rate of adverse events.
References
[1]: https://www.sciencedirect.com/science/article/pii/S2211568423002395
[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542160/
[3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9971280/
[4]: https://www.uclahealth.org/medical-services/radiology/interventional-radiology/treatments-procedures/genicular-artery-embolization-gae
[5]: https://www.indianavascular.com/blog/how-successful-is-the-genicular-artery-embolization-procedure
