Genicular Artery Embolization (GAE) in Spokane
Minimally Invasive Treatment for Chronic Knee Pain in Spokane
Chronic knee pain can make walking, climbing stairs, exercising, working, and other everyday activities more difficult. For many adults, persistent knee pain is related to osteoarthritis, a whole-joint condition that can involve cartilage loss, changes in the bone, and inflammation of the tissues lining the joint.
At Peak IR, our interventional radiologists offer genicular artery embolization, or GAE, in Spokane Valley for appropriately selected patients with symptomatic knee osteoarthritis. GAE is a minimally invasive, image-guided procedure designed to reduce abnormal blood flow associated with inflamed tissue around the knee. It does not remove or replace the joint.
Patients whose knee pain continues despite conservative care can connect with a specialist to discuss whether GAE or another treatment option may fit their needs.
Understanding Knee Osteoarthritis & Chronic Knee Pain
Knee osteoarthritis is more than simple wear of the cartilage. It affects multiple structures within the joint and can be associated with synovitis, or inflammation of the joint lining. In some patients, inflamed tissue develops increased small-vessel blood flow, also called hypervascularity or pathologic neovascularization.
The Society of Interventional Radiology describes chronic synovitis and abnormal new blood-vessel growth as contributors to osteoarthritis-related pain in some patients. GAE is designed to target this vascular component of the disease rather than rebuild cartilage or correct the structural changes of osteoarthritis.
Common symptoms of knee osteoarthritis include:
- Pain during or after activity.
- Stiffness after rest or when first getting up.
- Swelling or tenderness around the knee.
- Difficulty walking, bending the knee, or climbing stairs.
- Reduced range of motion.
- Grinding, clicking, or catching sensations.
Knee pain can also come from meniscal or ligament injuries, inflammatory arthritis, infection, fracture, referred pain, or other conditions. Identifying the source of symptoms is important before deciding whether embolization is appropriate.
When Should You See a Specialist for Knee Pain?
An evaluation may be appropriate when knee pain persists despite activity modification, exercise or physical therapy, medication, or injections, or when symptoms begin to interfere with mobility and daily activities. Persistent swelling, loss of motion, or worsening function should also be assessed.
Sudden severe pain after an injury, an inability to bear weight, a hot or markedly swollen joint, fever, or other concerning symptoms may require prompt medical evaluation rather than an elective GAE consultation.
How Is Osteoarthritis-Related Knee Pain Evaluated?
Evaluation starts with the pattern of pain, how long symptoms have been present, prior treatments, medical history, physical examination, and available imaging. X-rays are commonly used to evaluate osteoarthritis and the degree of structural joint change. MRI or other imaging may be considered when another diagnosis is suspected or when additional detail could affect treatment planning.
If GAE is being considered, the interventional radiologist also reviews vascular anatomy, medication use, kidney function when relevant to contrast administration, and other health factors that can influence procedural risk or candidacy.
Genicular Artery Embolization at Peak IR
GAE is performed by an interventional radiologist using fluoroscopy and angiography to navigate very small arteries around the knee. The goal is to reduce abnormal hypervascularity associated with inflamed synovial or periarticular tissue while protecting normal circulation.
Accessing the Arteries
The procedure begins with arterial access through a small puncture, commonly in the groin or wrist depending on anatomy, physician technique, and patient-specific considerations. A thin catheter is advanced through the blood vessels toward the genicular arteries under imaging guidance.
Identifying Abnormal Hypervascularity
Angiography helps the physician evaluate the genicular arterial network and identify areas of increased blood flow associated with inflamed tissue. Selective imaging is used to distinguish treatment targets from vessels supplying normal skin, bone, and other structures.
Targeted Embolization
Once an appropriate target is identified, embolic material is delivered through a microcatheter to reduce abnormal blood flow. GAE does not block all circulation to the knee and is not intended to damage normal tissue. Careful catheter positioning and imaging are used to reduce the risk of non-target embolization.
Comparing Your Knee Osteoarthritis Treatment Options
Knee osteoarthritis treatment is individualized. The best option depends on symptoms, structural joint changes, previous treatment, overall health, and patient preferences. GAE is one potential option within a broader treatment pathway, not a replacement for every form of nonsurgical or surgical care.
Feature
Genicular Artery Embolization (GAE)
Knee Replacement Surgery
Steroid Injections
Physical Therapy
Approach
Image-guided, minimally invasive
Open surgical procedure
Medication injected into joint
Strengthening and mobility exercises
Hospital Stay
Outpatient
1–3 days
Outpatient
Outpatient
Recovery Time
2–5 days
6–12 weeks
Short-term relief
Ongoing commitment
Effectiveness
Long-lasting pain relief
Highly effective
Temporary improvement
Helps manage symptoms
Anesthesia
Local with sedation
General or spinal
Local
None
Ideal Candidates
Moderate to severe knee pain from arthritis
Severe joint damage
Mild to moderate arthritis
Early-stage or post-treatment care
For a more detailed comparison, see Peak IR’s Genicular Artery Embolization vs. Knee Replacement resource.
What to Expect During GAE
The exact workflow varies by patient and by the arteries that need to be evaluated, but a typical GAE visit may include:
1
Reviewing symptoms, imaging, medications, and the procedural plan.
2
Preparing and numbing the arterial access site.
3
Guiding a catheter toward the arteries around the knee under fluoroscopy.
4
Performing selective angiography to identify abnormal hypervascularity and protect non-target vessels.
5
Delivering embolic material through a microcatheter when an appropriate target is confirmed.
6
Monitoring the access site and providing individualized discharge and activity instructions.
Procedure time varies with vascular anatomy and technical complexity. GAE is commonly performed in an outpatient setting, and many patients go home the same day after an appropriate period of observation.
What Is Recovery Like After Genicular Artery Embolization?
Recovery after GAE is generally less intensive than recovery after knee replacement because the procedure does not involve a large surgical incision or replacement of the joint. Patients may experience temporary soreness at the access site, bruising, transient knee discomfort, or skin changes depending on the vessels treated and the embolic material used.
Activity recommendations vary. Patients should follow the instructions provided by their interventional radiologist rather than relying on a fixed online recovery timeline. Some people return to routine activities relatively quickly, while others may need more time based on symptoms, access site, medical history, and the specific procedure performed.
Pain relief, when it occurs, is not necessarily immediate. Improvement may develop over the following weeks and can continue over several months. Individual response varies.
Who Is a Candidate for GAE?
The 2026 Society of Interventional Radiology position statement supports GAE as a treatment option for appropriately selected patients with symptomatic knee osteoarthritis who have not obtained adequate relief from conservative therapy and who are not candidates for, or wish to delay, total knee arthroplasty.
Candidacy is not determined by a single symptom or X-ray grade. The physician considers whether osteoarthritis is the likely source of pain, the severity and pattern of symptoms, previous treatment, imaging findings, vascular anatomy, and medical conditions that could increase procedural risk.
GAE is not intended to treat every source of knee pain. Infection, acute fracture, significant instability, or another diagnosis requiring different management should be addressed appropriately before embolization is considered.
How Long Can GAE Results Last?
Published observational studies have reported improvements in pain and function lasting for months and, in some cohorts, one year or longer. However, the magnitude and durability of benefit remain uncertain because higher-quality sham-controlled randomized trials have shown mixed results.
A 2025 systematic review of sham-controlled randomized trials concluded that GAE may provide short-term symptomatic relief in selected patients, while a 2026 meta-analysis noted that recent sham-controlled data make the size of the treatment effect uncertain. This is why GAE should not be described as guaranteed or permanently effective.
Does Insurance Cover Genicular Artery Embolization?
Insurance coverage for GAE varies by carrier, plan, diagnosis, medical-necessity criteria, and local policy. Prior authorization or documentation of previous conservative treatment may be required. Because coverage can change, patients should verify current benefits and expected out-of-pocket costs before treatment.
Peak IR can help review insurance information and determine whether authorization requirements apply to a planned procedure.
Advanced, Image-Guided Precision
GAE uses real-time imaging to identify small genicular arteries supplying areas of increased blood flow around the knee. This allows the interventional radiologist to selectively treat vessels associated with osteoarthritis-related inflammation while limiting treatment of surrounding tissue.
Why Choose Peak IR for GAE in Spokane?
Minimally Invasive, Outpatient Treatment
GAE is performed through a small arterial puncture, typically at the wrist or groin. A thin catheter is guided to the knee without open surgery, and most patients can return home the same day after a period of observation.
An Option for Selected Patients
GAE may be considered for patients with osteoarthritis-related knee pain that continues despite conservative care. It can also be discussed with patients who want to explore a minimally invasive option before knee replacement or who may not be ideal surgical candidates.
Experienced, Specialized Care
Peak IR’s interventional radiologists evaluate each patient’s symptoms, imaging, previous treatments, and health history before recommending GAE. Treatment is planned individually, with a clear discussion of potential benefits, limitations, alternatives, and risks.
Our Team
At the heart of Peak IR is a team of physicians who combine interventional radiology expertise with a local commitment to care.
Frequently Asked Questions
Is GAE painful?
Local anesthesia is used at the arterial access site, and sedation may be used when appropriate. Patients may feel pressure or temporary discomfort during or after the procedure. Experiences vary, and the care team can explain the planned anesthesia and pain-control approach before treatment.
Is GAE safe?
Published studies generally report a favorable safety profile, but GAE is not risk-free. Reported adverse events include access-site bruising or bleeding, temporary skin discoloration or irritation, transient knee discomfort, vascular injury, contrast-related complications, and non-target embolization. Rare complications have also been reported. Individual risks should be reviewed during informed consent.
Is GAE FDA approved for knee osteoarthritis?
GAE is performed clinically in the United States, but embolic agents used for musculoskeletal procedures do not currently have a formal FDA indication specifically for knee osteoarthritis. This is an off-label use of the embolic material. Off-label use can be medically appropriate when supported by clinical judgment and informed consent.
How long does GAE take?
Procedure time varies according to vascular anatomy, the number of arteries evaluated, and technical complexity. Many procedures are completed in an outpatient setting, followed by a period of observation before discharge.
When will I notice the results?
Improvement is not necessarily immediate. Some patients report changes during the first several weeks, and symptoms may continue to change over subsequent months. The timing and degree of improvement vary, and not every patient responds.
Does GAE cure knee osteoarthritis?
No. GAE does not rebuild cartilage, reverse structural osteoarthritis, or cure the condition. It is intended to reduce abnormal hypervascularity and inflammatory signaling that may contribute to pain in selected patients.
Can I still have knee replacement after GAE?
GAE is joint-preserving and does not replace the knee. Prior GAE does not inherently prevent later orthopedic surgery. Patients considering future knee replacement should share their complete treatment history with their orthopedic surgeon.
Will insurance cover GAE?
Coverage varies by insurance plan and medical-necessity policy. Patients should confirm benefits before treatment, and prior authorization may be required.
Take the First Step Toward Understanding Your Options
Persistent knee pain does not have a single treatment path. If osteoarthritis continues to affect mobility or daily activities despite conservative care, an evaluation can help clarify whether genicular artery embolization or another option may be appropriate.
Peak IR provides image-guided GAE in Spokane Valley for appropriately selected patients with osteoarthritis-related knee pain. Schedule a consultation to discuss your symptoms, prior treatment, and next steps.