Standardized angiographic workflow and technique for genicular artery embolization.

Area of Science:

• Interventional Radiology
• Orthopedics
• Vascular Medicine

Background:

• Chronic knee osteoarthritis (OA) significantly impacts quality of life for patients unresponsive to conservative treatments.
• Minimally invasive procedures are increasingly sought for OA management.
• Genicular artery embolization (GAE) shows promise as an alternative therapy.

Purpose of the Study:

• To describe a standardized, reproducible technical protocol for Genicular Artery Embolization (GAE).
• To detail imaging and embolization strategies for chronic knee OA.
• To provide a framework for the safe and precise application of GAE.

Main Methods:

• Development of a standardized protocol based on over 250 procedures at a single institution.
• Integration of sheathless femoral access and cone-beam computed tomography (CBCT) with advanced planning software.
• Selective embolization using resorbable or permanent agents in an outpatient setting.

Main Results:

• The described GAE protocol emphasizes safety, reproducibility, and precision.
• The technique facilitates outpatient procedures with same-day discharge and post-procedural physical therapy.
• This standardized approach can serve as a model for broader GAE implementation.

Conclusions:

• GAE is a safe and encouraging minimally invasive option for chronic knee OA.
• A standardized protocol enhances the precision and reproducibility of GAE.
• This technical report offers a framework for the wider adoption and standardization of GAE.