Ahmed Osman, Sajan Abin, Krishnasamy Venkatesh, Golzarian Jafar, Little Mark, Fleckenstein Florian, Okuno Yuji, Young Shamar, Sapoval Marc
Department of Radiology, The University of Chicago Medicine, Chicago, IL, USA.
Department of Radiology, Columbia University Medical Center, 622 W 168th St, New York, NY, 10032, USA.
Cardiovasc Intervent Radiol. 2025 Sep 16. doi: 10.1007/s00270-025-04188-3.
Symptomatic knee osteoarthritis is the most common joint disorder worldwide. Genicular artery embolization (GAE) is a minimally invasive therapy targeting abnormal knee neovascularity and inflammation, with potential to alter management paradigms. This review summarizes key evidence on its rationale, techniques, outcomes, and the need for standardization.
Peer-reviewed studies on GAE for knee osteoarthritis were assessed for patient selection, procedural technique, embolic agents, and reported outcomes.
GAE consistently achieved high technical success and short- to mid-term pain reduction, with improved VAS, WOMAC, and KOOS scores. Temporary and permanent embolic agents provide comparable results. Variability in vessel targets, embolic size, and periprocedural protocols limits direct comparisons and pooled analysis. Reported adverse events are uncommon, generally mild, and self-limited.
GAE offers a promising, image-guided option for symptomatic knee osteoarthritis. Standardized procedural methods, uniform outcome reporting, and robust multicenter trials are needed to confirm long-term safety and efficacy, optimize patient selection, and define GAE's role in osteoarthritis management.
症状性膝关节骨关节炎是全球最常见的关节疾病。膝动脉栓塞术（GAE）是一种针对膝关节异常新生血管和炎症的微创治疗方法，有可能改变治疗模式。本综述总结了关于其原理、技术、结果以及标准化需求的关键证据。
对关于GAE治疗膝关节骨关节炎的同行评审研究进行评估，内容包括患者选择、手术技术、栓塞剂以及报告的结果。
GAE始终取得了较高的技术成功率，短期至中期疼痛减轻，视觉模拟评分（VAS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及膝关节损伤和骨关节炎疗效评分（KOOS）均有所改善。临时性和永久性栓塞剂的效果相当。血管靶点、栓塞大小和围手术期方案的差异限制了直接比较和汇总分析。报告的不良事件并不常见，一般较轻且为自限性。
GAE为症状性膝关节骨关节炎提供了一种有前景的、影像引导的治疗选择。需要标准化的手术方法、统一的结果报告以及有力的多中心试验来证实长期安全性和有效性，优化患者选择，并确定GAE在骨关节炎治疗中的作用。
