Cardiovascular and interventional radiology · 2025
One- and Two-Year Outcomes of Genicular Artery Embolization for Symptomatic Knee Osteoarthritis: A Single-Center, Retrospective Study Using 200-µm Polyethylene Glycol Microspheres.
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Badar Wali, Al-Qawasmi Faisal, Alkhani Layth, Varadhan Ajay, Sajan Abin, Yu Qian, Anitescu Magdalena, Ross Brendon, Wallace Sara, Patel Mikin, Ahmed Osman
Аннотация
PURPOSE: To evaluate one- and two-year outcomes of genicular artery embolization (GAE) using 200-µm permanent microspheres in patients with symptomatic knee osteoarthritis (KOA) and identify predictors of clinical response. Long-term GAE outcome data are sparse but necessary to understand durability of the intervention.
MATERIAL AND METHODS: A single-center, IRB-approved retrospective study including 34 consecutive patients received GAE for symptomatic KOA from September 2021 to January 2024. GAE was performed using 200-µm polyethylene glycol microspheres. Clinical outcomes were assessed with the Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scoring system at pre-GAE visit and up to 2 years post-GAE. A 20% reduction in the WOMAC pain score at 1 and 2 years was considered clinically significant as well as by the OARSI-Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria Initiative and the Outcome Measures in Rheumatology criteria (OMERACT). Kaplan-Meier analysis was performed to investigate clinical response over time. Univariate and multivariate analysis was performed for gender, race, age, BMI, vessels treated, embolic volume, Kellgren-Lawrence (KL) grading using Fisher and t-tests.
RESULTS: Thirty-four patients and 42 knees were treated with KOA severity: KL3 ≥ 90%. One-year proportion of clinical response by MCID: 23.8% (95% CI 13.9-40.9) and by OMERACT: 21.4% (95% CI 12.0-38.2). Two-year proportion of clinical response by MCID: 19.8% (95% CI 10.4-38.0) and by OMERACT: 16.1% (95% CI 7.2-36.1). Adverse event rate was 30.1%. BMI was predictive of categorical response (univariate: P = 0.012 and multivariate: P = 0.033).
CONCLUSION: GAE using 200-µm PEG microspheres shows modest long-term outcomes for KOA with acceptable safety profile.
MATERIAL AND METHODS: A single-center, IRB-approved retrospective study including 34 consecutive patients received GAE for symptomatic KOA from September 2021 to January 2024. GAE was performed using 200-µm polyethylene glycol microspheres. Clinical outcomes were assessed with the Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scoring system at pre-GAE visit and up to 2 years post-GAE. A 20% reduction in the WOMAC pain score at 1 and 2 years was considered clinically significant as well as by the OARSI-Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria Initiative and the Outcome Measures in Rheumatology criteria (OMERACT). Kaplan-Meier analysis was performed to investigate clinical response over time. Univariate and multivariate analysis was performed for gender, race, age, BMI, vessels treated, embolic volume, Kellgren-Lawrence (KL) grading using Fisher and t-tests.
RESULTS: Thirty-four patients and 42 knees were treated with KOA severity: KL3 ≥ 90%. One-year proportion of clinical response by MCID: 23.8% (95% CI 13.9-40.9) and by OMERACT: 21.4% (95% CI 12.0-38.2). Two-year proportion of clinical response by MCID: 19.8% (95% CI 10.4-38.0) and by OMERACT: 16.1% (95% CI 7.2-36.1). Adverse event rate was 30.1%. BMI was predictive of categorical response (univariate: P = 0.012 and multivariate: P = 0.033).
CONCLUSION: GAE using 200-µm PEG microspheres shows modest long-term outcomes for KOA with acceptable safety profile.