Episode # 3 • 17 Jan 2025
Controversies in GAE: Patient Selection Techniques
Could genicular artery embolization (GAE) one day be offered before knee osteoarthritis sets in, or before a knee replacement to ease recovery? These interventional radiologists do not all agree. On this episode of the BackTable 2026 MSK Creator Weekend™, Dr. Osman Ahmed, Dr. Ahmed Farag, and Dr. Ally Baheti work through the biggest debates in GAE, starting with the ideal candidate, when it is too early to offer the procedure, how they approach Kellgren-Lawrence grade 4 knees, when a repeat embolization makes sense, and whether MRI with or without contrast is needed before treatment.
This podcast is supported by an educational grant from Guerbet.
Timestamps
00:00 - Introduction
00:57 - The Ideal GAE Candidate and When It Is Too Early
03:58 - Advanced Kellgren-Lawrence Grades and Repeat Embolization
08:50 - MRI, Contrast, and CO2 Angiography
13:32 - Young Athletes With Posttraumatic Arthritis
16:31 - Prophylactic and Preoperative GAE: Future Indications?
21:21 - Emerging Indications From Fractures to Checkpoint Inhibitor Arthropathy
23:53 - Reading the Sham-Controlled Trials
27:00 - How Many Vessels to Treat and the Superior Patellar Artery
33:17 - Blush, Occlusion Catheters, and Retrograde Embolization
39:07 - Choosing an Embolic and On-Label Temporary Agents
42:57 - Closing Remarks
Resources
- Okuno Y, et al. Midterm Clinical Outcomes and MR Imaging Changes after Transcatheter Arterial Embolization as a Treatment for Mild to Moderate Radiographic Knee Osteoarthritis Resistant to Conservative Treatment. J Vasc Interv Radiol. 2017
- Ahmed O, et al. Society of Interventional Radiology Position Statement on Genicular Artery Embolization for Symptomatic Knee Osteoarthritis. J Vasc Interv Radiol. 2026
- Bagla S, et al. Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis. J Vasc Interv Radiol. 2022
- van Zadelhoff TA, et al. Long-term outcomes of genicular artery embolization for knee osteoarthritis: 12-month efficacy and secondary outcomes from a randomized sham-controlled clinical trial. Eur Radiol. 2026
- Dr. Ally Baheti, BackTable contributor page
- Dr. Osman Ahmed, BackTable contributor page
- Dr. Ahmed Farag, BackTable contributor page
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More about this episode
The panel then turns to young athletes with posttraumatic arthritis, emerging indications from rheumatologic flares to checkpoint inhibitor arthropathy, and how to read the sham-controlled trials. They compare how many geniculate arteries they treat, whether to embolize the superior patellar artery, what blush really means, occlusion catheters and retrograde embolization, and how an on-label temporary or resorbable embolic could change practice in the office-based lab.
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