Genicular Artery Embolization
(GAE) in New York City

In osteoarthritic joints, abnormal new blood vessels (neovascularization) grow into the joint lining alongside nerve fibers. These vessels are directly responsible for amplifying pain signals — they are not present in healthy joints. GAE selectively blocks these abnormal vessels using microspheres delivered through a catheter. As the neovascular tissue resolves, the inflammatory pain cycle is disrupted, resulting in meaningful and durable pain reduction. Healthy blood supply to the joint is preserved.

Published clinical studies consistently report meaningful pain reduction lasting 12–24 months in the majority of GAE patients, with some patients maintaining benefit well beyond that. It is important to understand that GAE treats the pain-generating neovascular tissue — it does not halt the underlying arthritis progression. If symptoms return over time, the procedure can be repeated in appropriate candidates.

Yes. Prior steroid injections or PRP do not disqualify you from GAE — in fact, GAE is often most appropriate for patients whose injections provided only short-lived or inadequate relief. The mechanisms are different: injections reduce localized inflammation temporarily, while GAE targets the neovascular tissue responsible for sustained pain signaling. Dr. Fischman will review your full treatment history during consultation.

GAE can significantly reduce pain and improve function, potentially delaying the need for joint replacement for months to years. For some patients — particularly those who are not ideal surgical candidates due to age, weight, or health conditions — GAE may be a long-term management strategy rather than a bridge to surgery. However, because GAE addresses pain rather than the structural arthritis itself, joint replacement may eventually be required in patients with advanced disease. GAE does not compromise or preclude a future joint replacement if one becomes necessary.

GAE has a well-established safety profile in published literature. The most common side effects are transient — mild soreness or warmth around the treated joint lasting a few days. Because Dr. Fischman performs GAE under fluoroscopic imaging guidance with careful angiographic mapping before embolization, non-target embolization (accidental blockage of vessels not intended for treatment) is rare when performed by an experienced operator. As with any catheter-based procedure, there are small risks of access site bruising, contrast allergy, and infection, all of which are discussed in detail during your consultation.

Insurance coverage for GAE is evolving rapidly. Some major commercial insurance plans now cover GAE for knee osteoarthritis; others still classify it as investigational. Medicare coverage varies by region and clinical circumstances. Dr. Fischman's team at Mount Sinai will conduct a thorough insurance verification and prior authorization review for every patient before scheduling the procedure. Contact our office at (212) 241-4046 to begin the coverage assessment process.

Yes. Dr. Fischman welcomes patients from across the United States and internationally for GAE consultations and procedures. Initial consultations can be conducted via telemedicine, and the procedure itself is a same-day outpatient procedure — many out-of-state patients travel to New York City and return home the same day or the following morning. Our team coordinates closely with referring physicians and can assist with logistics for traveling patients.

Radiofrequency ablation (RFA) for joint pain works by destroying the sensory nerves that transmit pain signals from the joint — it is a nerve-blocking approach. GAE works upstream by reducing the abnormal neovascular tissue that amplifies those pain signals in the first place. RFA is performed by pain management specialists using needles placed near specific nerves; GAE is performed by interventional radiologists using a catheter through the vascular system. Both are non-surgical approaches, and some patients with inadequate response to RFA have benefited from GAE, and vice versa. Dr. Fischman will help determine which approach — or combination — is most appropriate for your specific case.