Cynthia Schraf-Fletcher, 74, gardens without wincing now—her right knee, once a source of relentless pain, moves with ease nearly a year after undergoing genicular artery embolization (GAE) at the University of Colorado Anschutz School of Medicine. For her, the outcome rivals the total knee replacement she had on her other side, but without the lengthy recovery. “I couldn’t be more pleased,” she says, describing a transformation that’s restoring not just mobility but joy in everyday life. GAE, a minimally invasive procedure led by Dr. Leigh Casadaban, assistant professor of radiology, is emerging as a vital middle ground for the millions suffering from chronic knee pain due to osteoarthritis—a condition that wears down joint cartilage and leads to inflammation, swelling, and often, surgical intervention. Until now, treatment options have been limited: conservative measures like physical therapy or medications, or major surgery like total joint replacement. GAE fills a critical gap for those who haven’t found relief but aren’t ready for a scalpel.
The procedure works by targeting the root of inflammation. Using X-ray guidance, an interventional radiology team threads a catheter through the femoral artery to the genicular arteries feeding the knee. There, they release microscopic beads that block abnormal blood vessels contributing to pain and swelling. The entire process takes just one to two hours under conscious sedation, and patients like Schraf-Fletcher go home the same day. Early results are compelling: about 70% of patients see their pain scores cut in half, with some achieving complete relief. In Japan, where the procedure originated over a decade ago, four-year data shows sustained benefits—pain relief lasting years from a single outpatient visit. In the U.S., two-year data confirms durability for those who respond well, suggesting GAE may do more than mask symptoms—it could be modifying the disease process itself.
Dr. Casadaban is now leading two clinical trials at CU Anschutz to deepen understanding of how GAE works. One examines changes in knee joint fluid post-procedure, while the other tests a new temporary embolization device called Nexsphere-F, designed to target inflammation more precisely. Though currently used only for knees, the potential extends further. Early exploration is underway for treating frozen shoulder, tennis elbow, and plantar fasciitis—opening a new frontier in non-surgical joint care. With FDA breakthrough device designation granted to several GAE tools since 2021, momentum is building. For patients caught between pills and prosthetics, GAE isn’t just a new option—it’s a reimagining of what pain relief can look like.