Geniculate Artery Embolization: A Concise Review

Osteoarthritis (OA) is one of the most prevalent causes of chronic disability worldwide, yet current therapeutic options often provide incomplete or short-lived relief, particularly for patients who are not surgical candidates. Genicular artery embolization (GAE) has emerged as a minimally invasive endovascular therapy that directly targets synovial inflammation and abnormal neovascularization, both key drivers of OA pain. Over the past decade, prospective studies and early randomized trials have demonstrated meaningful improvements in pain, function, and quality of life following GAE, with durability of effect extending up to 2 years in selected patients. Imaging studies consistently support reductions in synovial volume and vascularity without evidence of cartilage injury, while safety data confirm a low rate of mostly minor, self-limited complications. Patient selection, embolic material choice, and technical considerations remain important factors influencing outcomes. This review synthesizes current clinical, imaging, and anatomical evidence on GAE, highlighting its role as a promising mechanism-based therapy that bridges the gap between conservative management and surgical intervention in knee OA.