Before Your Procedure
Pre-Op Instructions
What you need to know and do before your Genicular Artery Embolization (GAE).
📅 Review as soon as possible
Important — Read Carefully
Fasting Before Your Procedure
🚫 No Solid Food
8 hours before your arrival time
✅ Clear Liquids OK
Up to 2 hours before arrival
✅ Clear Liquids Include
Water · Black coffee · Plain tea · Apple juice · Broth
💊
Medications
In general, continue ALL medications as normal. Dr. Fischman will review your specific medications at your consultation and advise you of any changes needed. Take morning medications with a sip of water within the clear liquid window.
Exception: Do NOT take diabetic medications (insulin or oral diabetes pills) the night before or morning of the procedure.
Arrange an escort (18+). A responsible adult must escort you from the procedure area, drive you home, and stay with you for several hours. Car service or rideshare is not acceptable unless no sedation was given.
Plan 1 day off for rest after the procedure, then resume activity as tolerated.
Notify us of any allergies to contrast dye, iodine, shellfish, or medications.
Notify us if you take a GLP-1 medication (Ozempic, Wegovy, Mounjaro, Victoza, Trulicity) or have sleep apnea — both affect sedation.
Notify us of any kidney disease. Contrast dye is used and special precautions may be needed.
Stock up on ibuprofen or naproxen — NSAIDs will be your primary pain relief for 3–5 days after the procedure. If you cannot take NSAIDs, let us know.
Confirm imaging (X-ray or MRI of the affected joint) has been sent to our team.
Lab work is generally not required. Dr. Fischman will advise at consultation if any is needed.
📞
Nurse Call — Afternoon
One of our nurses will call you in the afternoon on the day before your procedure to review your instructions, answer questions, and confirm your arrival time and which location your procedure will be at. Please keep your phone available and charged.
Eat normally during the day. Fasting begins 8 hours before your assigned arrival time.
No alcohol for at least 24 hours before your procedure.
Shower tonight or morning of. No lotions, creams, or deodorant on the groin area.
Wear loose, comfortable clothing. The catheter is placed through your groin — avoid tight waistbands or restrictive pants.
Leave jewelry and valuables at home.
Have an ice pack ready at home for use on the treated joint after the procedure.
No solid food within 8 hours of arrival. Clear liquids OK until 2 hours before — then nothing by mouth.
Take all regular medications with a sip of water, within the clear liquid window. Skip diabetic medications.
Where to go: Go to the location our nurse confirms on the call the day before:
• 1468 Madison Avenue — MC Level, Room 801, Interventional Radiology
• 1000 10th Avenue (between W 58th & W 59th St) — 4th Floor, Interventional Radiology Registration
Arrive at the time confirmed by our nurse the afternoon prior. Late arrival may result in rescheduling.
Bring: Photo ID · Insurance card · Medication list · Any imaging not already sent to us.
Your escort (18+) must be present and able to take you home. Car service or rideshare is not acceptable unless no sedation was given.
What to Expect
Procedure Day
A step-by-step walkthrough of your GAE procedure day at Mount Sinai Interventional Radiology.
⏱️ Plan for approximately half a day
GAE (Genicular Artery Embolization) is a minimally invasive procedure that treats chronic joint pain from osteoarthritis. In osteoarthritis, abnormal new blood vessels grow into the joint lining and drive pain signals. GAE reduces blood flow to these vessels, calming inflammation and significantly reducing pain.
Dr. Fischman accesses the joint arteries through a tiny catheter, most often inserted in an artery at your foot (tibial artery), and less commonly at your groin — no surgery, no general anesthesia, and you go home the same day.
🦴 Joints Treated
Dr. Fischman performs GAE for osteoarthritis-related chronic pain in the knee, shoulder, and hip. The knee is the most commonly treated joint. Your specific joint will have been discussed at your consultation.
1
Check-In & Registration
Arrive at the location our nurse confirmed the day before — 1468 Madison Ave (MC Level, Room 801) or 1000 10th Ave (4th Floor). Paperwork and insurance verification completed.
2
Pre-Procedure Prep
Nurse places your IV and reviews medical history, medications, and allergies. Vital signs monitored throughout.
3
Consent
A physician (MD) or advanced practice provider (PA or NP) will review and obtain your informed consent.
4
Sedation
IV sedation keeps you relaxed and comfortable. You'll be drowsy but able to respond. No general anesthesia.
5
Foot or Groin Access
Dr. Fischman numbs the access site with local anesthesia and inserts a small catheter — most often into the tibial artery at your foot, and less commonly into the femoral artery at your groin. You will feel pressure but should not feel pain.
6
The Procedure (~1 hour)
Using live X-ray (fluoroscopy), Dr. Fischman guides the catheter to the arteries feeding the affected joint and delivers microspheres to reduce blood flow to the abnormal pain-driving vessels.
7
Recovery (~2 hours)
You rest in recovery while vital signs and the access site are monitored. If the catheter was placed in your groin, you will need to lie flat for a period to allow the site to seal.
8
Discharge & Home
IV removed, discharge instructions provided. Your escort takes you home the same day.
After Your Procedure
Post-Op Instructions
What to expect during recovery and how to care for yourself after GAE.
📆 Follow-up in 6 weeks
Expected After the Procedure
Pain relief from GAE is typically gradual — most patients notice meaningful improvement over 4–8 weeks as inflammation subsides. Some temporary discomfort at the treated joint and at the access site (foot or groin) is normal immediately after.
Soreness or aching at the treated joint for a few days
Mild bruising or tenderness at the access site — the top of the foot or ankle (foot access) or a small lump at the groin (groin access) — usually resolves within 1–2 weeks
Fatigue or feeling "off" for 24–48 hours
Mild swelling at the treated joint — apply ice as needed
Rest for 1 day after the procedure, then resume activity as tolerated.
Weight-bearing is allowed immediately — walk as comfortably as you can.
No heavy lifting (>10 lbs) for 48 hours to allow the access site to heal.
No driving for 24 hours after sedation.
Ice the treated joint as needed for comfort — 15–20 minutes at a time, with a cloth between the ice and skin.
No baths, hot tubs, or pools for 5 days. Shower after 24 hours, keeping the access site dry initially.
Avoid sexual activity for 5–7 days.
Resume normal diet immediately — stay well hydrated.
💊 NSAIDs (ibuprofen or naproxen)
Take as directed for 3–5 days after the procedure to reduce inflammation and manage discomfort. Take with food. Do not exceed the recommended dose. If you have kidney disease or cannot take NSAIDs, contact us before taking them.
🧊 Ice
Apply ice to the treated joint as needed for comfort. Use 15–20 minutes at a time with a cloth between the ice pack and your skin. Do not apply ice directly to the access site on your foot or groin.
⚠️
Blood Thinners
Do NOT restart blood thinners unless specifically instructed by our team. Dr. Fischman will advise you on when to resume them.
📍 Both Sites — General Care
Small bruise or firmness at the puncture site — normal, resolves over 1–2 weeks
Keep the site clean and dry for the first 24 hours
A small bandage will be placed — you may remove it after 24 hours
Call 9-1-1 for any bleeding from the site that does not stop with 15 minutes of firm pressure
🦶 Foot Access (most common)
Mild tenderness or bruising on the top of the foot or ankle is normal. Walking is fine.
Wear loose, comfortable shoes that don't press on the puncture site for the first few days
Call us if you notice increasing swelling, redness, or warmth of the foot or ankle
Call 9-1-1 if your foot or toes become cold, pale, blue, or numb
📍 Groin Access (less common)
A small, firm lump under the puncture site is normal and will soften over 1–2 weeks
Call us if you notice increasing swelling, a rapidly growing lump, or significant new bruising spreading down the thigh
Call Us
Worsening joint pain not controlled by NSAIDs and ice
Increasing swelling, redness, or warmth at the access site (foot or groin)
Leg swelling, calf pain, or numbness in the leg
Any symptoms that concern you or feel unexpected
Call 9-1-1 or Go to ER
Uncontrolled bleeding from the access site (foot or groin) that won't stop with 15 minutes of firm pressure
Sudden coldness, pallor, or numbness of the leg or foot — possible vascular emergency
Chest pain or sudden shortness of breath
Severe allergic reaction: hives, throat tightening, face swelling
Loss of consciousness or extreme confusion
🗓️ 6 Weeks
Follow-up appointment with Dr. Fischman — available in-person or via telemedicine — to assess pain relief, function, and recovery progress.
📈 When to Expect Results
Pain relief from GAE is gradual. Most patients notice meaningful improvement over 4–8 weeks. Continue your normal activity as tolerated during this time.