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A panel of musculoskeletal and interventional radiologists (IRs), selected based on clinical experience, scientific expertise and geographic diversity, scored each response using a 10-point Likert-scale across three rounds. Consensus was predefined as\u2009\u2265\u200975% of ratings\u2009\u2265\u20097\/10.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-nine IRs completed all three rounds. Consensus inclusion criteria for GAE include knee pain refractory to conservative treatment for\u2009\u2265\u20093\u00a0months due to osteoarthritis, tendinopathies or prior knee surgery and recurrent hemarthrosis (median 9[IQR 7\u201310]; 86%\u2009\u2265\u20097). Pre-procedural assessment should include standardized outcome measures, clinical examination and knee radiographs. Contrast-enhanced MRI is optional for osteoarthritis phenotyping and grading of synovitis, differential diagnosis and outcome prediction (8[7\u201310]; 79%\u2009\u2265\u20097). Via an ipsilateral antegrade transfemoral access, all visible genicular arteries should be catheterized and embolized upon detection of a hypervascular blush (9[7\u201310]; 76%\u2009\u2265\u20097). No evidence of superiority of either temporary or permanent embolic agents in terms of safety or efficacy has been demonstrated (10[8\u201310]; 86%\u2009\u2265\u20097). Structured long-term follow-up is recommended, with clinical success defined as achievement of the minimal clinically important difference or individual patient satisfaction (9[7\u201310]; 83%\u2009\u2265\u20097). Contralateral or repeat GAE may be considered for bilateral knee pain, insufficient response or pain recurrence (8[7\u201310]; 76%\u2009\u2265\u20097).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This Delphi study establishes expert-derived consensus recommendations for GAE, emphasizing broad indications, patient-tailored technique and an active role of the IR in multidisciplinary longitudinal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00270-026-04547-8","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T20:34:19Z","timestamp":1784752459000},"page":"1702-1714","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Genicular Artery Embolization for Chronic Knee Pain: Expert Consensus Recommendations on Indications, Technique and Clinical Care Using a Delphi Process"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3532-7383","authenticated-orcid":false,"given":"A.","family":"Taheri Amin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Golzarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Abd El Tawab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Abu-Gharbieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Assis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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Carnevale to Francisco Cesar Carnevale in the author list.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2026","order":8,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":9,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":10,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00270-026-04646-6","URL":"https:\/\/doi.org\/10.1007\/s00270-026-04646-6","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Arian Taheri Amin: No potential conflicts of interest relevant to this article exist. Jafar Golzarian: No potential conflicts of interest relevant to this article exist. Karim Abd El Tawab: No potential conflicts of interest relevant to this article exist. Lina Abu-Gharbieh: No potential conflicts of interest relevant to this article exist. Osman Ahmed: Merit Medical (speaker), Guerbet (investigator initiated grant), Trisalus (consultant), Nexsphere (advisory board member). Andre Assis: No potential conflicts of interest relevant to this article exist. Amin Astani: No potential conflicts of interest relevant to this article exist. Christoph Binkert: No potential conflicts of interest relevant to this article exist. Francisco Cesar Carnevale: No potential conflicts of interest relevant to this article exist. Frederico Cavalheiro: No potential conflicts of interest relevant to this article exist. Federico Collettini: Member of scientific advisory board of NextBiomedical, Clinical advisor to Guerbet, SIRTEX, Asahi, Terumo, MAGLE PharmaCept, Medtronic, AstraZeneca. Research grants from Terumo, Asahi, MAGLE PharmaCept, Philips, Siemens. Mateus Picada Correa: No potential conflicts of interest relevant to this article exist. Ali Dablan: No potential conflicts of interest relevant to this article exist. Karthikeyan Damodharan: No potential conflicts of interest relevant to this article exist. Yan Epelboym:\u00a0Consultant to Guerbet, TriSalus Life Sciences, and Instylla. Research grant from Guerbet. Ana Mar\u00eda Fern\u00e1ndez: No potential conflicts of interest relevant to this article exist. Dimitrios Filippiadis: No potential conflicts of interest relevant to this article. Gerard S. Goh: No potential conflicts of interest relevant to this article. Ali Guermazi: Consultant to Novartis, TissueGene, ICM, Medipost, Scarcell, 4Moving, Peptinov, Coval, Pacira, Formation Bio, Paradigm, and Levicept. He is Shareholder of BICL, LLC and Editor in Chief of Skeletal Radiology. Ziv Haskal: Member of scientific advisory board of NextBiomedical. Anna Maria Ierardi: No potential conflicts of interest relevant to this article. Marcus Katoh: No potential conflicts of interest relevant to this article. Mark Little: Clinical advisor to CrannMed, Merit medical, Varian medical, Guerbet, Microbot medical, Asahi, Boston scientific. Research grants Varian and Merit medical. Yuji Okuno: Member of scientific advisory board of NextBiomedical. Siddharth A. Padia: Research grant: Varian, Boston Scientific. Consultant: Boston Scientific, Crannmed, Asahi, BD, Delcath, Immunocore, MeritNassir Rostambeigi: No potential conflicts of interest relevant to this article. Marc Sapoval: Consultant for Guerbet. Co-owner of the patient on Lipiodol based emulsion; Research grant by Guerbet. Bedros Taslakian: Clinical advisor to CrannMed. Founder & CEO TaslakianMD; Consulting Siemens; Consulting for Guerbet. Raman Uberoi: No potential conflicts of interest relevant to this article. Hendryk Vieweg: No potential conflicts of interest relevant to this article. Farid Ziayee: No potential conflicts of interest relevant to this article. Peter Minko: Consultant to Merit Medical and Nano4Imaging. Research grant NextBiomedical.","order":1,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study did not involve human participants, patient data, or any intervention requiring ethical approval. As a Delphi consensus study based solely on expert opinion, no institutional review board approval was required.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors have reviewed the manuscript and consent to its publication.","order":3,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was not required, as this study did not involve human participants or patient data.","order":4,"name":"Ethics","label":"Informed Consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}