The ESIR 2025 course on MSK embolization took place from October 16-17. It is among the first MSK embolization courses to incorporate an in vivo animal lab training component. Prof. Peter Minko and Dr. Arian Taheri-Amin coordinated the use of the animal material already generated during the training for further scientific analysis.
Prof. Minko, you recently led hands-on, in vivo animal lab trainings during the ESIR course on MSK embolization in Strasbourg. What led you to do so?
Minko: When I first came across Dr. Yuji Okuno’s early publications on genicular artery embolization, I was fascinated by the concept and its potential to transform how we manage musculoskeletal pain. At that time, I was in Homburg, and we were among the first centers in Germany to start exploring this technique. Seeing its promise firsthand convinced me that MSK embolization will become an important pillar of interventional radiology.
That’s why I was eager to bring this topic to the ESIR curriculum – to share the experience, to teach the nuances of the procedure, and to help others appreciate both its technical and clinical potential. Preparing the course required careful coordination with CIRSE, industry partners, and the dedicated team in Strasbourg, but the effort was absolutely worth it, and the enthusiasm of the participants confirmed how much momentum this field is gaining.
Dr. Taheri-Amin, you had the idea to examine the porcine knee joints after their use in the GAE training. What were some of the preparations you undertook to execute this idea?
Taheri-Amin: The idea came to me quite spontaneously. I remember standing in the shower when I thought: Why not use the porcine knees from the ESIR course for research as well? When I pitched it to Prof. Minko, I honestly expected him to laugh it off. But in his usual way, he immediately shared my enthusiasm and did everything he could to make it happen.
From that moment on, things moved incredibly fast. Together with our research team — and especially with Paula Krüselmann, who was instrumental in organizing the logistics — we managed to design and implement the entire project within just a few weeks. It was a huge team effort, and seeing it come to life was incredibly rewarding.
The 3Rs principle (replacement, reduction, and refinement) is an EU-mandated method to protect animals used for scientific purposes. Could you explain the design of the study on genicular artery embolization (GAE) that you are conducting and how it integrates the 3Rs principle?
Minko: Animal welfare and ethical responsibility have always been very important to me, and they influence how I design studies and organize teaching activities. In interventional radiology, despite the remarkable progress we’ve made with simulation-based training, there are still aspects of procedural learning and research that require in vivo settings to truly understand physiological responses and device behavior. That said, it’s our clear obligation to minimize animal use and adhere to the 3Rs principle in every possible way.
When Arian approached me with the idea of using the porcine knees from the GAE training for additional analyses, I was immediately excited. It was such an elegant concept – turning a necessary educational setup into an opportunity for high-quality research without additional animal use.
Taheri-Amin: Absolutely. The 3Rs principle is at the heart of how we structured this project. Instead of performing additional animal experiments, we used the porcine knees from the existing training course to conduct an exceptionally comprehensive series of analyses.
It’s remarkable what we accomplished within such a short time frame: in roughly eight hours, we collected over 500 blood samples and more than 300 tissue specimens — all systematically labeled, processed, and preserved for further analysis. From these samples, we will be able to assess more than 2,000 molecular, structural, and histological parameters.
Why is it important to study embolic agents in MSK embolization, especially from an in vivo, comparative perspective?
Minko: The discussion about the “ideal” embolic agent is currently one of the hottest topics in the field. The main debate centers around temporary versus permanent embolic materials. Personally, I don’t believe there will ever be a single, universal answer to that question. I think we’re moving away from a one-size-fits-all concept toward a patient-specific selection of embolic agents and tailored embolization endpoints.
The reason why comparative studies are important is simple: to choose the right embolic agent for our patients, we first need to understand the molecular and biochemical processes each material induces. Only by understanding the intervention on a micro-level can we achieve the best possible results on a patient level.
What particularly fascinates me is how a permanently occluding material can produce similar clinical results to a temporary one that recanalizes within hours. With our in vivo study on GAE, we wanted to take a step closer to understanding these underlying biological mechanisms.
What advantages do porcine knee joints offer in studying embolic materials?
Minko: Anatomically and physiologically, the porcine vascular system, especially around the knee, closely resembles the human situation, which makes it an excellent translational model. The vessel size, branching patterns, and overall tissue response allow us to perform procedures under highly realistic conditions.
Dr. Taheri-Amin, you also participated in the course. What was the experience like? How did the topic relate to your PhD thesis?
Taheri-Amin: My main research focus is on interventional pain medicine, particularly on transarterial microembolization as a minimally invasive treatment for chronic musculoskeletal pain. So, this course was an absolute highlight for me, and it even sparked several research ideas that I’m now pursuing in the context of my thesis. It was an outstanding learning experience that motivates young physicians like me to push the field forward.
What feedback did you receive from participants about the in vivo training sessions?
Minko: The feedback was overwhelmingly positive. Many participants expressed how valuable it was to experience GAE in such a realistic and structured environment, and they were engaged not only technically but also scientifically. While my research team was collecting blood samples in the angio suites, several attendees asked insightful questions about our study. That level of interest shows that we’re fortunate to have a community that’s focused on both clinical excellence and advancing the science behind our field.
What new insights or inspiration did you gain from this experience?
Minko: What I find remarkable about this project is the perfect symbiosis that my team managed to organize – combining research and education in a way that maximizes scientific value while strictly adhering to the 3Rs principle. With minimal additional effort, we were able to turn a hands-on training course into a meaningful translational study. The next step is to build on this experience, incorporate the feedback from CIRSE as well as the course participants and our faculty colleagues, and make this integrated concept a part of future ESIR courses. I believe it represents the direction in which interventional education and innovation should continue to evolve.
Taheri-Amin: Being part of this ESIR course was a privilege. The organizational structure, level of expertise, the openness to discussion, and the genuine passion of the faculty created an environment that was both intellectually stimulating and personally motivating. I learned not just about the technical aspects of MSK embolization but also about how education and mentorship can shape the next generation of interventional radiologists. I’m extremely grateful to CIRSE, the ESIR organizers, and faculty for allowing me to be part of this unique experience. I left Strasbourg with a head full of new ideas and a heart full of appreciation.
