GENICULAR ARTERY EMBOLISATION MELBOURNE

What is Genicular Artery Embolisation (GAE)? – GAE is a minimally invasive treatment that may reduce persistent knee pain caused by osteoarthritis.

Using fluoroscopic (X-ray) guidance, an interventional radiologist guides a thin catheter into selected genicular arteries supplying the knee. Tiny particles are delivered to reduce abnormal blood flow associated with inflammation and pain without stopping the knee’s essential circulation. GAE is usually performed under local anaesthetic with sedation.

GAE may be considered when non-surgical treatments have not provided sufficient pain relief, knee replacement is unsuitable or a less invasive option is preferred before major knee surgery. It may benefit selected patients with persistent pain or recurrent bleeding after knee replacement surgery.

Most patients return home the same day after the procedure. Pain relief may develop gradually over several weeks. Results and recovery vary from patient to patient.

Source: UCLA Health – Genicular Artery Embolisation

GENICULAR ARTERY EMBOLISATION – Procedure summary:

Used for: Persistent knee pain caused by osteoarthritis
Aims: Reduce swelling and pain & improve knee function
Patient suitability: May suit patients whose knee osteoarthritis pain has not improved sufficiently with non-surgical treatments and not ready for knee replacement surgery
Procedure type: Minimally invasive, image-guided procedure
Procedure time: Approximately 60–90 minutes
Anaesthetic: Local anaesthetic with sedation
Post surgical pain management: Closely managed for 24 hours and monitored for 7-14 days

Hospital stay: Usually a day procedure
Recovery/activity: Light activity under doctor’s advice
Results: Aim for improvement over several weeks (varies between patients)
Risks and side effects: May include bruising, knee pain, skin discolouration, fatigue or a mild fever – See FAQ’s for risks
Patient referral & assessment: A specialist consultation, review and imaging are required
Performed by: Specialist interventional radiologist
Technical success rate: 99.7% (Source: National Library of Medicine).

Please note: GAE may help reduce symptoms but does not repair damaged cartilage or cure osteoarthritis. Results vary amongst patients. Your doctor will discuss the potential benefits, limitations and risks with you during your consultation.

HOW IS A GENICULAR ARTERY EMBOLISATION PERFORMED?

Genicular Artery Embolisation – A Genicular Artery Embolisation is a minimally invasive operation which is performed through a 2-3 mm hole through the artery in the groin.

Using real-time imaging, a microcatheter, a small hollow plastic tube, is carefully navigated into the genicular arteries which supply blood to the knee joint.

Once in position, microscopic particles are injected into the local arteries, until there is reduced blood supply to the lining of the knee joint. By blocking these arteries, there is a reduction in the amount of inflammation associated with osteoarthritis helping to reduce the associated knee pain.

The operation typically takes 60 – 90 minutes, and can be safely performed under sedation and local anaesthesia.

Most patients experience pain relief within weeks of the procedure.

Source: UCLA Health – Genicular Artery Embolisation

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WHO IS A SUITABLE CANDIDATE FOR A GAE?

A GAE may be suitable for you if you have:

Knee pain caused by osteoarthritis
Failed other non-operative management such as steroid injections, pain killers and physiotherapy
Suffered side effects from pain killers
Mild to moderate osteoarthritis – Medical literature suggests a GAE may be less effective for end stage or severe osteoarthritis
Wish to avoid a major knee operation.

A GAE only requires local anesthesia and sedation, has minimal risks, and has a quick recovery time compared to traditional open surgery.

Please note – GAE does not repair damaged cartilage or cure osteoarthritis. Its purpose is to reduce inflammation and pain and potentially improve everyday function.

GAE MAY NOT BE SUITABLE FOR EVERYONE

GAE may not be appropriate for patients whose knee pain is unrelated to osteoarthritis or have advanced arthritis, an active infection, circulation problems, certain kidney conditions, a significant contrast allergy or are pregnant. Some medications may also need to be safely paused before treatment. Dr Chan will assess your individual circumstances and advise whether GAE is suitable for you.

WHERE DOES GAE FIT IN KNEE OSTEOARTHRITIS TREATMENT?

Treatment usually progresses from conservative (non-operative) care such as activity modification, physiotherapy and pain medication to invasive treatments such as corticosteroid injections, GAE and knee replacement surgery. GAE may fit in before considering knee replacement surgery, depending on the severity of the arthritis, symptoms and individual health needs.

See below for a treatment guide:

Treatment stage	Options	When it may be considered
1. Initial conservative care	Activity modification, weight management, exercise, physiotherapy and supportive footwear	Usually the first approach for managing pain, stiffness and reduced mobility
2. Pain management	Paracetamol, anti-inflammatory medication or other prescribed medicines	When additional symptom relief is required alongside exercise and lifestyle measures
3. Joint injections	Corticosteroid or other clinically appropriate injections	When pain continues despite initial non-surgical treatment
4. Genicular artery embolisation (GAE)	Minimally invasive, image-guided treatment targeting abnormal blood vessels associated with inflammation	When non-surgical treatments have not provided sufficient relief, knee replacement is unsuitable or a less invasive option is preferred before surgery
5. Knee replacement surgery	Partial or total knee replacement	Generally considered for advanced arthritis causing severe pain and loss of function when other treatments are no longer effective

ADVANTAGES OF GENICULAR ARTERY EMBOLISATION

A Genicular Artery Embolisation procedure has the following advantages:

High technical success rates – 99.7% intended arteries embolised
Minimally invasive – Performed through a small 2–3 mm arterial puncture using a thin catheter and image guidance, reducing tissue disruption compared with traditional open surgery
Usually performed as a day procedure – GAE does not normally require the hospital stay. Discharge may vary between patients
Potential pain relief – At 12 months after GAE, 78% of patients achieved a clinically meaningful improvement in knee pain
Low rate of serious complications in published studies
Most reported side effects are temporary – These may include bruising, temporary knee discomfort or skin discolouration
Allows most patients to return early to rehabilitation programs when compared to traditional open surgery.

Medical reference: National Library of Medicine – Taslakian B, Miller LE, Mabud TS, et al. Genicular artery embolization for treatment of knee osteoarthritis pain: Systematic review and meta-analysis. Osteoarthritis and Cartilage – Review involving 270 patients and 339 treated knees. View reference

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PREPARING FOR A GENICULAR ARTERY EMBOLISATION

Your doctor and the WIRES Radiology team will discuss with you the procedure process and hospital administration needs including:

What to bring – Bring your referral, relevant scans or reports, medication list, Medicare card and private health insurance details, if applicable.

Investigations and tests – You may require more relevant investigations such as blood tests, ultrasound, CT or MRI as part of your preparation for the procedure.

Fasting and overnight hospital stay – Generally, you are required to fast for 6 hours before the procedure. Please prepare for an overnight hospital stay (even if you are expecting to be discharged the same day).

Medications, allergies and medical conditions – Your doctor will review your list of medications and advise which medications you may need to stop before the procedure and when you may resume taking them again. Inform the team if you have a contrast allergy, kidney condition, diabetes or any other significant medical condition or allergies.

Driving – Have someone to drive you home after the procedure.

RECOVERY – AFTER A GENICULAR ARTERY EMBOLISATION

Going home – Most patients can expect to go home the same day.

Pain management – Your knee pain will likely worsen before it improves and is usually worse in the first 12-24 hours after the procedure. You may also notice some skin mottling over the treatment area, which should improve over the next 1 to 2 months.

Post embolisation syndrome – Post embolisation syndrome is caused by the body’s reaction to the operation. Patients often feel fatigued, have low grade fever, nausea, vomiting, low appetite, generalised muscle and joint aches – similar to having a cold without the head symptoms.

These symptoms may be managed with paracetamol and ibuprofen, and may resolve after 7-14 days. Your doctor will discuss with you and answer any questions you may have in relation to your post procedure recovery.

Activity and rehabilitation – Light activity can be resumed gradually according to your doctor’s advice. Dr Chan will discuss driving, returning to work, physiotherapy, medications and follow-up care with you.

When to seek medical advice – Contact your treating team if pain or swelling becomes severe, symptoms are worsening rather than improving, or you develop persistent fever, increasing redness, bleeding or unusual changes in the treated leg.

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FREQUENTLY ASKED QUESTIONS

Is a Genicular Artery Embolisation painful?

Genicular Artery Embolisation is usually well-tolerated as it is a minimally invasive interventional radiology procedure performed under local anaesthetic.

Immediately after the procedure – After the procedure, some patients experience mild to moderate soreness, swelling, or aching in the knee.

Most patients feel only mild discomfort or pressure as the catheter is inserted and guided to the knee’s blood vessels. A local anesthetic is used at the insertion site, which helps minimise pain.

Post surgery – Pain relief from the procedure’s effects on knee inflammation often begins within a week or two. Any post-procedure pain is generally manageable with over-the-counter medications.

Is GAE covered by Medicare or private health insurance?

Please ensure you check:

GP OR SPECIALIST REFERRAL: Yes – Required for Medicare rebates and private health insurance eligibility.

PRIVATE HEALTH FUND COVER: Generally a Silver level hospital cover is required to be covered by private health insurance (please confirm with your insurer).

If you don’t have adequate cover, self funded is an option – Please reach out to the team to discuss.

Patients without private health insurance are not eligible for treatment at the private hospital. Medicare rebates will still apply to consultations with a valid referral.

How long is the recovery time after a Genicular Artery Embolisation?

A Genicular Artery Embolisation is generally a 60 – 90 minute procedure. Most patients can expect to return home the same day.

Light activities – Light activities can typically be resumed within two weeks following the procedure.

High-impact activities – We recommend avoiding high-impact activities for at least four weeks after the procedure.

Important note – Please discuss your rehabilitation and return to any activities with your doctor.

What results may I expect after a Genicular Artery Embolisation?

First month – After your initial recovery period of 1 month, most patients may see a significant reduction in knee pain.

Ongoing relief – Although Genicular Artery Embolisation does not provide a permanent cure for knee osteoarthritis, it may provide significant knee pain relief for 1-3 years.

What imaging is required before a Genicular Artery Embolisation?

Your doctor may request a recent knee X-ray and MRI to assess the severity of osteoarthritis, inflammation and other possible causes of pain. Additional imaging may occasionally be required depending on your medical history.

Dr Chan will review your results and advise whether GAE may be suitable for you.

Does a Genicular Artery Embolisation cure osteoarthritis?

No – GAE does not cure osteoarthritis or restore damaged cartilage. It aims to reduce abnormal blood flow and inflammation within the knee, which may relieve pain and improve mobility. Results vary, and some patients may require additional treatment in the future.

What are the risks from a Genicular Artery Embolisation?

GAE is generally well tolerated, like all medical procedures, it carries potential risks. These may include but no limited to:

Bruising, bleeding or discomfort at the catheter insertion site
Temporary increase in knee pain or swelling
Temporary skin discolouration, rash or mottling around the knee
Temporary numbness or altered sensation
Infection
Allergic reaction
Kidney problems
Damage to or blockage of a blood vessel
Embolisation particles reaching an unintended area

Serious complications have been uncommon in published studies, but individual risks vary. The medical team will monitor you closely, and Dr Chan will explain the benefits and risks relevant to your circumstances before treatment.

Are there any side effects from a Genicular Artery Embolisation?

Common side effects may include mild pain, fever, and temporary discomfort. Serious complications are rare but can include issues with the arteries or surrounding organs.

Your doctor will fully explain the procedure and any potential side effects and mitigation strategies to make you as comfortable as possible during and after the procedure.

Results - How soon might I notice an improvement after GAE?

Pain relief is not always immediate. Some patients may notice an improvement within the first few weeks, while others may take longer. Pain and mobility may continue to improve gradually over several months. Results vary from patient to patient depending on individual circumstances.

Activities - How soon might I be able drive and return to work and undertake light to high impact activities after GAE?

Light activities – Most patients can gradually return to light activities within a few days.

Driving – You will need someone to drive you home after the procedure and should not drive until you can move comfortably, react safely and are no longer taking medication that may cause drowsiness.

Returning to work – Returning to work will depend on your recovery and the physical demands of your job. Dr Chan will provide personalised advice.

High-impact activities – We recommend avoiding high-impact activities for at least four weeks after the procedure. Dr Chan will provide personalised advice.

MESSAGE FROM DR CHAN:

This information is designed to help you understand GAE and prepare for your procedure. As every patient is different, not all details may apply to you. I am happy to answer your questions during your consultation, or you can contact the WIRES Radiology team.

Dr Philip Chan – MBBS, MMed (Radiology), FRANZCR, EBIR-ES
Interventional Radiologist

If you have any questions about Genicular Artery Embolisation please contact WIRES Interventional Radiology.

Your doctor will be able to give you a better understanding of your unique medical situation:

VISIT CONTACT INFORMATION

Proud member of The Royal Australian and New Zealand College of Radiologists and
The Interventional Radiology Society of Australasia.

GENICULAR ARTERY EMBOLISATION FOR KNEE OSTEOARTHRITIS
WIRES INTERVENTIAL RADIOLOGY

Dr Philip Chan and the WIRES Interventional Radiology team provide consultations for Genicular Artery Embolisation (GAE) and knee osteoarthritis at three convenient Melbourne locations.

Epping – Northern Private Hospital, Northern Blood & Cancer Care, Suite 4, 12 Osburn Place, Epping VIC 3076. Convenient for patients from Epping, Lalor, Thomastown, Mill Park, Wollert, South Morang, Bundoora, Reservoir and Melbourne’s northern suburbs.

Surrey Hills – Union Road Specialists Centre, 203 Union Road, Surrey Hills VIC 3127. Welcoming patients from Surrey Hills, Hawthorn, Balwyn, Burwood, Box Hill, Doncaster, Blackburn and Melbourne’s eastern suburbs.

Box Hill – Epworth Eastern, 1 Arnold Street, Box Hill VIC 3128. Conveniently located for patients from Box Hill, Balwyn, Doncaster, Kew, Hawthorn, Ringwood, Glen Waverley and surrounding areas.

GENICULAR ARTERY EMBOLISATION MELBOURNE

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