Quantifying Change in Perfusion after Genicular Artery Embolization with Parametric Analysis of Intraprocedural...

Area of Science:

• Interventional Radiology
• Vascular Imaging
• Osteoarthritis Treatment

Background:

• Genicular artery embolization (GAE) is used to treat osteoarthritis pain.
• The "pruning" technique aims to reduce hyperemic blood flow in genicular arteries.
• Parametric analysis can quantify perfusion changes during GAE.

Purpose of the Study:

• To quantitatively assess perfusion changes in genicular arteries during GAE using parametric analysis.
• To correlate embolization volume with adverse events.

Main Methods:

• 12 patients underwent unilateral GAE, with 36 vessels embolized.
• Regions of interest (ROIs) were placed on parent vessels (PVs) and target vessels (TVs).
• Peak intensity (PI), time to arrival (TTA), and area under the curve (AUC) were computed before and after GAE.

Main Results:

• GAE significantly reduced AUC and PI in TVs, while increasing TTA, indicating decreased perfusion.
• No significant perfusion changes were observed in PVs.
• Clinical symptoms improved significantly at 1 and 3 months post-GAE.
• Mild adverse events occurred, with skin changes noted in knees receiving >3.0 mL of embolic material.

Conclusions:

• Parametric analysis quantifies reduced perfusion in target genicular arteries post-GAE.
• GAE demonstrates acceptable clinical outcomes for osteoarthritis.
• Embolic volume appears to correlate with the risk of nontarget embolization and adverse events.