By Dr. John Hogg, MD, DABR, DABVLM — Founder and Board-Certified Vascular Specialist, Medical Vein Clinic San Antonio | Published October 1, 2025
Genicular Artery Embolization, or GAE, is a minimally invasive outpatient procedure for chronic knee pain caused by osteoarthritis. It works by reducing blood flow to the inflamed lining of the knee joint, decreasing pain and swelling without surgery. The procedure takes 30 to 60 minutes, requires no general anesthesia, and most patients go home the same day. Relief typically begins within two weeks and lasts three to five years. GAE is an option for patients who have tried conservative treatments for at least six months and want to avoid or delay knee replacement surgery. It can also help patients who have had knee replacement but still experience pain. Medical Vein Clinic in San Antonio offers GAE performed by board-certified vascular surgeon Dr. Thomas Gianis. Most major insurance plans cover GAE when knee osteoarthritis has been documented and conservative treatments have been attempted for at least six months. Medicare also covers GAE in qualifying cases. Medical Vein Clinic verifies your insurance coverage before your appointment so you know your costs upfront. Call 210-622-8000 to confirm your benefits. 30 million Americans live with knee pain from osteoarthritis — GAE gives many of them a non-surgical path forward.
A Message from Dr. Hogg, Founder of Medical Vein Clinic
If chronic knee pain is compromising your life, making it hard to climb stairs, enjoy your morning walks, or get comfortable at night, I want you to know there’s real hope. You don’t have to just wait around until your knees get bad enough for replacement surgery.
Here at Medical Vein Clinic, we’re offering an innovative treatment, Genicular Artery Embolization, or GAE. It’s a minimally invasive procedure for people with knee arthritis pain. This procedure addresses the root cause of this pain, delivering pain relief that lasts.
How GAE Works: Targeting the Source of Knee Inflammation
Before GAE, Dr. Gianis reviews your imaging and medical history to confirm you are a good candidate. Most patients complete pre-procedure bloodwork and bring documentation of prior treatments, including physical therapy records and injection history.
Let me explain what makes GAE different. Instead of waiting for your arthritis to get so bad that knee replacement is your only choice, we can step in earlier and tackle the problem where it starts.
Your knee has small blood vessels called geniculate arteries that bring blood to different parts of the joint. When you have arthritis, these arteries can get a little too active, feeding all that swelling and inflammation in your knee lining that makes everything hurt and feel stiff. What we do with GAE is carefully dial down the blood flow to those trouble spots so the inflammation calms down naturally.
In this procedure, we use imaging to guide us to exactly the right spot through a tiny opening. No big incisions, no stitches, and you won’t need to be put completely under anesthesia. With GAE, we deliver microscopic particles to the problem vessels, which reduces the blood flow that’s been feeding the knee inflammation.
What to Expect Before, During, and After GAE
When you have GAE done here at Medical Vein Clinic, plan on being with us for about 30 minutes to an hour. We’ll give you some IV medicine to keep you comfortable and relaxed, though you’ll be awake the whole time. Because of the medication, you’ll need someone to drive you home and stay with you for the day, but most people are surprised at how easy the recovery is.
A lot of our patients start feeling better within a couple of weeks, and that relief usually sticks around for three to five years. What makes me happiest is seeing patients get back to doing the things they love. Maybe it’s chasing after the grandkids again, working in the garden without wincing, or just taking a walk around the block without thinking twice about it.
Clinical studies published in the Journal of Vascular and Interventional Radiology show that approximately 90% of GAE candidates experience significant knee pain improvement following the procedure.
Follow-up appointments are scheduled to monitor your improvement. If needed, GAE can be repeated.
Who Qualifies for GAE? Candidacy Criteria Explained
I’m a big believer in trying the basics first before we move to procedures like GAE. You’re probably a good fit for this if you’ve already spent at least six months working with physical therapy, taking over-the-counter pain medicines, getting steroid shots or gel injections, and trying other treatments your pain doctor or orthopedic surgeon recommended.
Here’s something that might surprise you: GAE can even help people who’ve had knee replacements but are still dealing with pain, as long as your orthopedic doctor thinks it’s a good idea.
You might want to consider GAE if you’re dealing with:
- Knee pain that’s really bothering you, whether it’s one knee or both
- Pain that gets in the way of everyday activities like going upstairs
- Stiffness when you first get up in the morning
- Having to take pain medication regularly
- Not being ready for knee replacement surgery, or maybe it’s not the right choice for you.
Knee osteoarthritis affects more than 32 million adults in the United States, according to the Centers for Disease Control and Prevention.
Why Patients Choose Medical Vein Clinic for GAE in San Antonio
What sets us apart isn’t just the procedure itself, but the experience and care we bring to it. We work hand-in-hand with all your other doctors to make sure GAE fits into your overall health and treatment plan. This collaborative approach means you’re not just getting a procedure. You’re getting complete care that’s tailored to your particular health needs.
Does Insurance Cover Genicular Artery Embolization?
Most insurance companies cover GAE treatment for osteoarthritis pain, which means this innovative option is available to patients who need it most.
Schedule Your GAE Consultation at Medical Vein Clinic San Antonio
You don’t have to let chronic knee pain run your life. GAE gives you another option between trying everything else and having surgery. It helps you stay active and independent while keeping other choices open for the future.
You deserve to have knees and a life that aren’t limited by pain, and we’re here to get you there.
Meet Your GAE Specialist: Dr. Thomas Gianis, Board-Certified Vascular Surgeon
The GAE procedure at Medical Vein Clinic is performed by Dr. Thomas Gianis, MD, FACS, FSVS, DABVLM, RPVI — a board-certified vascular surgeon and Fellow of the American College of Surgeons. Dr. Gianis completed his fellowship in vascular and endovascular surgery at the University of Virginia Medical School and has treated hundreds of patients for knee pain and peripheral artery disease. He is recognized for his technical precision and his commitment to explaining every step of the procedure to patients while it is being performed. Dr. Gianis sees GAE patients at both Medical Vein Clinic locations in San Antonio.
To learn more about Genicular Artery Embolization or to schedule a consultation, contact Medical Vein Clinic today. Your journey toward lasting knee pain relief starts with a conversation. Call Medical Vein Clinic at 210-622-8000 or book your GAE consultation online at medicalveinclinic.com/book-an-appointment. We have two San Antonio locations: Stone Oak at 18831 Meisner Drive and Northwest San Antonio at 5742 W. Loop 1604 N. Free consultations are available.
Healthy Legs Take You Further™.
Frequently Asked Questions About GAE for Knee Pain
What is Genicular Artery Embolization?
GAE is a minimally invasive procedure for knee arthritis pain that addresses the root cause rather than just masking it. The geniculate arteries feed the knee joint, and in arthritis they become overactive, fueling the inflammation that causes pain and stiffness. GAE delivers microscopic particles to dial down that blood flow so the inflammation calms naturally.
How is GAE different from knee replacement?
GAE steps in earlier, before arthritis is bad enough that replacement is the only option. It uses a tiny opening with no big incisions, no stitches, and no full anesthesia, while replacement is major surgery. GAE also keeps your other options open, including replacement later if you ever need it.
Is GAE painful?
No. You receive IV medication to keep you comfortable and relaxed, and you stay awake the whole time. Because the procedure goes through a tiny opening rather than an incision, recovery is easy, and most patients are surprised at how simple it is.
How long does the procedure take?
Plan on being at the clinic for about 30 minutes to an hour. Because of the IV medication, you’ll need someone to drive you home and stay with you for the day.
How long does GAE relief last?
Many patients start feeling better within a couple of weeks, and that relief usually lasts three to five years. Because GAE calms the source of the inflammation, the results tend to hold.
Am I a candidate for GAE?
You’re likely a good fit if you’ve already tried the basics for at least six months, such as physical therapy, over-the-counter pain medicine, steroid shots, or gel injections, without enough relief. GAE suits moderate to severe knee pain in one or both knees, morning stiffness, or reliance on pain medication. It can even help people who’ve had a knee replacement but still have pain, if their orthopedic doctor agrees.
Does insurance cover GAE?
Yes. Most insurance companies cover GAE treatment for osteoarthritis pain. We verify your benefits before your procedure so you understand your coverage. Call 210-622-8000 to confirm.
Who performs GAE at Medical Vein Clinic?
GAE is performed by board-certified vascular surgeon Dr. Thomas J. Gianis II, who has treated hundreds of patients for peripheral artery disease and knee pain. He works hand-in-hand with your other doctors so GAE fits your overall treatment plan.
Dr. John Hogg, MD, DABR, DABVLM, RPVI, RPhS, RVT, RVS, is a board-certified radiologist specializing in Vascular & Interventional Radiology and the CEO/Founder of Medical Vein Clinic. With over 30 years of experience, Dr. Hogg has established San Antonio’s leading vascular treatment clinic, helping thousands of patients since 2017. To learn more, visit https://www.medicalveinclinic.com.
