Standardized angiographic workflow and technique for genicular artery embolization

Genicular artery embolization (GAE) has emerged as a safe and encouraging minimally invasive treatment option for patients with chronic knee osteoarthritis (OA) who have failed conventional therapies. This technical report describes a standardized imaging and embolization protocol developed at a single institution, based on over 250 procedures. The technique integrates sheathless femoral access, routine use of cone-beam computed tomography (CBCT) with advanced embolization planning and guidance software, and a selective embolization strategy using resorbable or permanent agents. Procedures are performed in an outpatient setting, with same-day discharge and routine post-procedural physical therapy. The method described emphasizes safety, reproducibility, and precision, and provides a potential framework for broader standardization in GAE.