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GAE was performed using permanent microspheres. Clinical outcome was assessed at 6\u00a0weeks, 3, 6, 9, and 12\u00a0months using the numeric rating scale (NRS). Minimal clinically important difference (MCID) was defined as an improvement of at least 2 points compared with baseline. Patients failing to achieve MCID at 6\u00a0months underwent reGAE. Angiographic blush size before and after embolization during GAE and reGAE was measured and compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 55 patients (87 GAEs), a median of 4 (range, 2\u20136) vessels was treated, with a median total embolic volume of 4.5\u00a0mL (1.5\u201310.1\u00a0mL). After initial GAE, 23 patients (42%) achieved MCID. Following reGAE at 6\u00a0months, an additional 20 patients (36%) reached MCID, with sustained efficacy up to 6\u00a0months after reGAE (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0001); 12 patients (22%) remained non-responders. Quantitative angiographic analysis demonstrated a significant increase in blush size within previously treated vessels, necessitating reGAE (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After GAE using permanent microspheres, reperfusion of previously treated vessels was observed at 6\u00a0months in all patients failing to achieve MCID. ReGAE increased the proportion of clinical responders, supporting its role as an effective additive treatment strategy in severe OA and post-TKR pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00270-026-04410-w","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:22:24Z","timestamp":1773832944000},"page":"1370-1381","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Repeated Genicular Artery Embolization Using Permanent Microspheres for Severe Osteoarthritis and Postsurgical Pain"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3532-7383","authenticated-orcid":false,"given":"A. 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