You’ve had your consultation with Dr. Chun, reviewed your imaging, discussed the evidence, and decided to move forward with genicular artery embolization. You know how the procedure works and what the clinical data shows. Now you want to know the practical details: what to do before, what happens on the day, and what recovery actually looks like.
This guide covers every step from the week before your procedure through your first follow-up appointment. Informed patients recover better, and there should be no surprises.
One to Two Weeks Before Your Procedure
Insurance authorization is confirmed. By the time you’re reading this, our insurance team should have already verified your coverage and provided you with an estimate of any out-of-pocket costs. If you haven’t received this information, contact our office at (240) 427-1630.
Medication review. Dr. Chun’s team will provide you with specific instructions about your medications. The general framework is as follows, though individual instructions may vary:
Medications that may need to be held or adjusted: Blood thinners (warfarin, apixaban/Eliquis, rivaroxaban/Xarelto, dabigatran/Pradaxa, clopidogrel/Plavix): your interventional radiologist and prescribing physician will coordinate the specific hold period and any bridging strategy. This is individualized based on your thrombotic risk. NSAIDs (ibuprofen, naproxen, meloxicam): typically held for 5–7 days before the procedure to reduce bleeding risk at the access site. Aspirin: in most cases, low-dose aspirin (81 mg) can be continued. Your team will confirm.
Medications that typically continue as usual: Blood pressure medications, statins, diabetes medications (with specific instructions about the morning dose if you’re fasting), thyroid medications, and most other daily medications. Take your morning medications with a small sip of water even during the fasting period.
Metformin note: If you take metformin for diabetes, you may be asked to hold it for 48 hours after the procedure due to the contrast dye used during angiography. Your team will provide specific instructions.
Arrange transportation. You will receive IV sedation and cannot drive for the remainder of the procedure day. Arrange for a companion, such as a family member or friend, to bring you home. A ride-share service is acceptable only if a companion accompanies you. This is non-negotiable; we will not perform the procedure if you don’t have a confirmed ride home.
Pre-procedure imaging. In most cases, your knee X-rays or MRI have already been reviewed during the consultation. If additional imaging is needed, it will be ordered and completed before the procedure date.
The Day Before
Evening meal. Eat a normal dinner. There are no dietary restrictions the day before, but avoid excessive alcohol consumption.
Prepare your outfit. Choose comfortable, loose-fitting clothing, particularly pants or shorts that are easy to pull on. If your access site will be the wrist (radial artery approach, which is Dr. Chun’s preferred approach), wear a shirt with sleeves that roll up easily. Avoid jewelry, watches, and rings on the access-site arm.
Confirm your schedule. Review your arrival time (typically 1–2 hours before the scheduled procedure), location, and the name and phone number of your driver.
Fasting. Follow the specific instructions provided, which typically involve nothing to eat or drink after midnight before the procedure. This includes gum, mints, and candy.
The Day of the Procedure
Arrival and Check-In (30–45 minutes)
You’ll arrive at the SACMD facility at your scheduled pre-procedure time. After check-in, you’ll change into a hospital gown and have an intravenous (IV) line placed by the nursing team. Vital signs (blood pressure, heart rate, oxygen saturation) will be taken. The nursing team will review your medical history, confirm your medications, and verify your allergies — particularly any history of contrast dye allergy or shellfish allergy.
Dr. Chun will come to speak with you before the procedure begins, review the plan, answer any final questions, and confirm which knee is being treated. This is your last opportunity to ask anything.
The Procedure (60–90 minutes)
Access. A small area of skin at the access site, typically the wrist (radial artery), is cleaned, numbed with local anesthetic, and punctured with a small needle. A thin catheter (approximately 2mm in diameter) is introduced through this puncture point. You may feel brief pressure at the access site but should not feel pain.
Sedation. Through your IV, you’ll receive conscious sedation, a combination of medications that make you relaxed, drowsy, and comfortable. You won’t be “asleep” in the way general anesthesia produces unconsciousness, but you will be in a deeply relaxed state and may not remember much of the procedure afterward. You’ll breathe on your own throughout, and your vital signs will be continuously monitored by the nursing team.
Navigation and angiography. Using real-time X-ray guidance (fluoroscopy), Dr. Chun navigates the catheter through your arterial system to the genicular arteries, the small branches that supply blood to the knee joint. A contrast dye injection creates a detailed angiographic map of the blood supply to your knee. This map reveals the areas of abnormal neovascularity — the pathological blood vessel networks in the inflamed synovial tissue — that appear as a characteristic “synovial blush” on the angiogram.
Embolization. Once the target vessels are identified, a microcatheter is positioned in each genicular artery feeding the areas of abnormal neovascularity. Tiny biocompatible microspheres (75–250 micrometers, smaller than a grain of sand) are injected through the microcatheter. These particles lodge in the abnormal microvessels, blocking blood flow to the inflamed tissue. Normal, healthy tissue in the knee continues to receive blood from its regular supply. The embolization is selective, targeting only the pathological vessels.
Multiple genicular arteries may be treated during the same session, depending on the distribution of neovascularity. Dr. Chun confirms adequate embolization with post-treatment angiography before completing the procedure.
Catheter removal and hemostasis. The catheter is withdrawn, and the wrist puncture site is compressed and closed with a hemostatic band or closure device. A small bandage is applied.
Recovery (1–2 hours)
You’ll be moved to a recovery area where nursing staff monitor your vital signs, check the access site for any signs of bleeding or swelling, and allow the sedation to wear off. Most patients feel alert and conversational within 30–60 minutes, though some grogginess may persist.
Once you’re stable, comfortable, and your access site is hemostatic, you’ll be discharged with your companion. You’ll receive written post-procedure instructions before you leave.
After the Procedure: The Recovery Timeline
Day 1 (procedure day). Rest at home. Mild soreness at the access site is normal. A small bruise may develop over the next few days. Keep the bandage clean and dry for 24 hours. Acetaminophen (Tylenol) is usually sufficient for any discomfort. Avoid aspirin and NSAIDs for 24 hours unless directed otherwise. Stay hydrated. The contrast dye used during the procedure is cleared through the kidneys, and adequate hydration supports this process.
Days 2–3. Most patients resume desk work and light daily activities. No heavy lifting (over 10 pounds) for the first 2–3 days, particularly with the access-site arm. Walking is encouraged. Short, comfortable walks are beneficial for circulation and recovery. You may notice that your knee feels roughly the same as before the procedure at this stage. That’s expected. GAE pain relief builds gradually.
Week 1. The access-site bandage can be removed. The puncture site may have a small bruise that fades over the next week. Resume all normal daily activities. Begin gentle exercise (walking, stationary cycling, swimming) as comfort allows. Avoid running, jumping, or intense impact activity for the first two weeks.
Weeks 2–4. This is when most patients begin to notice meaningful improvement in their knee pain. The change is typically gradual. Activities that previously caused significant pain become progressively more tolerable. You may resume moderate exercise and recreational activities. Continue any prescribed medications (including NSAIDs if previously prescribed for knee pain — Dr. Chun will advise).
Months 1–3. Full clinical response develops during this period as the inflammatory process continues to resolve. The NYU prospective trial showed 55.4% VAS pain reduction at 12 months, with improvements building through the first several months. Many patients describe the experience not as a dramatic “light switch” moment but as a gradual realization that their knee simply doesn’t limit them the way it used to. They may notice one day that they walked through the mall without stopping, or climbed stairs without thinking about it.
Your follow-up appointment. SACMD typically schedules a follow-up visit at approximately one month post-procedure. This is a brief assessment: symptom evaluation, discussion of any concerns, and confirmation that your recovery is on track. Additional follow-up is scheduled as needed based on your response.
What to Bring to Your Procedure
A practical checklist for procedure day: insurance card and photo ID, a list of your current medications (or the medication bottles themselves), your companion’s phone number (in case we need to contact them during recovery), comfortable, loose-fitting clothing, a light jacket or sweater (procedure rooms can be cool), your phone and charger (for the recovery period), and your questions, written down because sedation can make you forgetful.
What to leave at home: Jewelry, watches, and rings (particularly on the access-site hand). Valuables. Expectations of significant knee pain immediately after the procedure — recovery from GAE is uneventful for the vast majority of patients, and the knee improvement comes over weeks, not hours.
Frequently Asked Questions
The Bottom Line
GAE is designed to be one of the most straightforward procedures in medicine from the patient’s perspective: arrive, receive sedation, rest while the interventional radiologist works, go home the same day, and return to your life within days. The preparation is minimal, the recovery is brief, and the clinical evidence supports meaningful, durable improvement in knee OA pain.
If you have questions about preparing for your specific procedure, particularly regarding medication management or medical conditions, don’t hesitate to contact our office. That’s what we’re here for.
Schedule a consultation or ask procedure questions: Call (240) 427-1630 or visit www.sacmd.com
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Individual preparation instructions may vary. Follow the specific instructions provided by your care team.
References:
- Taslakian B, et al. Prospective GAE Trial. JVIR. 2025.
- Cusumano LR, et al. GAE 2-Year IDE Trial. JVIR. 2024;35(12):1768-1775.
- Cleveland Clinic. Preparing for an Angiogram. clevelandclinic.org.
- Mayo Clinic. Conscious Sedation — What to Expect. mayoclinic.org.
- ACR. Patient Safety — Contrast Dye and Metformin.
