Assessing the Effects of Geniculate Artery Embolization in a Nonsurgical Animal Model of Osteoarthritis

Uflacker, Andre; Keefe, N.; Bruner, Evelyn; Avery, Alexandra; Salzar, Robert S.; Henderson, Kyvory; Spratley, E. Meade; Nacey, Nicholas C.; Miller, G. Wilson; Grewal, Sukhdeep; Chahin, Jonathan; Safavian, Dana; Haskal, Ziv J.

doi:10.1016/j.jvir.2022.05.015

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…Recently, a ram model of knee osteoarthritis was evaluated by intra-arterial injection of mono-iodoacetate. Despite the limited number of treated knees (75 µm calibrated microparticles n = 2 and 250 µm calibrated microparticles n = 2), they showed the slow-down of inflammation progression after embolization on MRI, angiographic, and histologic analyses [23].…”

Section: Neoangiogenesismentioning

confidence: 93%

Feasibility of Neovessel Embolization in a Large Animal Model of Tendinopathy: Safety and Efficacy of Various Embolization Agents

Ghelfi

Soulairol

Stephanov

et al. 2022

JPM

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Targeting neovessels in chronic tendinopathies has emerged as a new therapeutic approach and several embolization agents have been reported. The aim of this study was to investigate the feasibility of embolization with different agents in a porcine model of patellar tendinopathy and evaluate their safety and efficacy. Eight 3-month-old male piglets underwent percutaneous injection of collagenase type I to induce patellar tendinopathies (n = 16 tendons). They were divided into four groups (2 piglets, 4 tendons/group): the control group, 50–100 µm microspheres group, 100–300 µm microspheres group, and the Imipenem/Cilastatin (IMP/CS) group. Angiography and embolization were performed for each patellar tendon on day 7 (D7). The neovessels were evaluated visually with an angiography on day 14. The pathological analysis assessed the efficacy (Bonar score, number of neovessels/mm2) and safety (off-target persistent cutaneous ischemic modifications and presence of off-target embolization agents). The technical success was 92%, with a failed embolization for one tendon due to an arterial dissection. Neoangiogenesis was significantly less important in the embolized groups compared to the control group angiographies (p = 0.04) but not with respect to histology (Bonar score p = 0.15, neovessels p = 0.07). Off-target cutaneous embolization was more frequently depicted in the histology of the 50–100 µm microspheres group (p = 0.02). Embolization of this animal model with induced patellar tendinopathy was technically feasible with different agents and allowed assessing the safety and efficacy of neovessel destruction. Particles smaller than 100 µm seemed to be associated with more complications.

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Section: Neoangiogenesismentioning

confidence: 93%

Feasibility of Neovessel Embolization in a Large Animal Model of Tendinopathy: Safety and Efficacy of Various Embolization Agents

Ghelfi

Soulairol

Stephanov

et al. 2022

JPM

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“…2 ). The SPA has a variable origin from the DGA or directly from the femoral artery and takes a characteristic serpiginous course in the anterior knee to the superior pole of the patella and is implicated in patellofemoral compartment OA synovial changes [ 11 ]. The superior lateral and medial compartments are supplied by the SLGA and SMGA, respectively.…”

Section: Methodsmentioning

confidence: 99%

Classification of Genicular Artery Anatomic Variants Using Intraoperative Cone-Beam Computed Tomography

Callese

Cusumano

Redwood

et al. 2023

Cardiovasc Intervent Radiol

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Purpose Genicular artery embolization (GAE) is a new treatment option for symptomatic knee osteoarthritis. Genicular arterial anatomy is complex with limited published reports. This study describes the genicular artery anatomy utilizing intraprocedural cone-beam computed tomography (CBCT) during GAE. Materials and Methods This retrospective single-center study was approved by the institutional review board. All patients who underwent GAE between May 2018 and April 2022 were reviewed. Patients with a technically adequate CBCT were included in the analysis. CBCTs were analyzed to determine the presence, course, and branching patterns of the genicular arteries. Results A total of 222 patients underwent GAE and 205 (92%) were included for analysis. The descending genicular artery was present in 197 (96%) CBCTs with two branches in 152 (77%). The superior medial genicular artery (SMGA) was present in 186 (91%), superior lateral genicular artery (SLGA) in 203 (99%), inferior medial genicular artery (IMGA) in 195 (95%), inferior lateral genicular artery (ILGA) in 196 (95%), and median genicular artery (MGA) in 200 (97%). Four unique branching patterns were identified: common origin of SLGA and MGA (115, 56%), unique origins (45, 22%), trifurcation of SLGA, SMGA, and MGA (32, 15.5%), and common origin of SMGA and MGA (12, 6%). The recurrent ascending tibial was identified in 156 (76%) CBCTs and superior patellar artery in 175 (85%) CBCTs. Conclusion Genicular artery anatomy is complex with numerous common variants. CBCT is a powerful adjunct in GAE to rapidly identify target vessels for embolization and potentially decrease the risk of nontarget embolization.

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“…GAE is an emerging treatment strategy for patients with knee OA who have failed to respond to nonsurgical interventions and are not yet suitable candidates for surgical intervention. Despite the promising results from previous trials demonstrating pain reduction, synovitis alleviation, and a low rate of major AEs, GAE research is still in its infancy, with a scarcity of in vivo studies providing detailed pathological evidence to support the procedure 58,61,62 .…”

Section: Overviewmentioning

confidence: 99%

Genicular Artery Embolization for Knee Osteoarthritis

Poursalehian,

Bhia,

Ayati Firoozabadi

et al. 2023

JBJS Reviews

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» Genicular artery embolization (GAE) is a promising treatment option for patients with knee osteoarthritis who are unresponsive to nonsurgical treatments and not yet candidates for surgery.» Current evidence supports the effectiveness of GAE in reducing pain and synovitis, with few reported major adverse events.» The cost-effectiveness and long-term results of GAE compared with other treatment options require further investigation.» Limitations of existing studies include small sample sizes, single-center trials, and lack of comparison between embolic agents and other treatments.» Future research should focus on larger, multicenter trials with longer follow-up periods and head-to-head comparisons with alternative treatment modalities to establish the role of GAE in the management of knee osteoarthritis.

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Assessing the Effects of Geniculate Artery Embolization in a Nonsurgical Animal Model of Osteoarthritis

Cited by 6 publications

References 21 publications

Feasibility of Neovessel Embolization in a Large Animal Model of Tendinopathy: Safety and Efficacy of Various Embolization Agents

Feasibility of Neovessel Embolization in a Large Animal Model of Tendinopathy: Safety and Efficacy of Various Embolization Agents

Classification of Genicular Artery Anatomic Variants Using Intraoperative Cone-Beam Computed Tomography

Genicular Artery Embolization for Knee Osteoarthritis

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