Descending genicular artery. Branching patterns and measuring parameters: A systematic review and meta-analysis of several anatomical studies

Ziegler, Thomas W.; Kamolz, Lars‐Peter; Vasilyeva, Anna; Schintler, Michael; Neuwirth, Maximilian; Parvizi, Daryousch

doi:10.1016/j.bjps.2018.03.005

Cited by 19 publications

(26 citation statements)

References 43 publications

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“…The distribution pattern of the DGA and the various distances were consistent with the literature, summarized in a recent exhaustive systematic review and meta‐analysis (Ziegler et al, 2018), although we did not observe the Type IIa pattern. We also observed an additional subtype of the Type I pattern in which the AB arises first from the common trunk, leaving behind a sapheno‐muscular trunk.…”

Section: Discussionsupporting

confidence: 92%

“…Anatomical studies of the DGA have sparked great interest in the recent years owing to the emergence and increasing indications of medial femoral condyle (MFC) flap (Dubois, Lopez, Puwanarajah, Noyelles, & Lauwers, 2010; Garcia‐Pumarino & Franco, 2014; Huang et al, 2011; Hugon, Koninckx, & Barbier, 2010; Sananpanich, Atthakomol, Luevitoonvechkij, & Kraisarin, 2013; Weitgasser et al, 2016; Xu, Zheng, Li, Zhu, & Ding, 2019; Ziegler et al, 2018). So far, anatomical studies of the DGA have been related to plastic surgery.…”

Section: Introductionmentioning

confidence: 99%

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Anatomical study of the descending genicular artery and implications for image‐guided interventions for knee pain

Fonkoué¹,

Behets²,

Steyaert³

et al. 2020

Clinical Anatomy

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Introduction The descending genicular artery (DGA) has recently been mentioned as accompanying some nerves in the medial aspect of the knee joint. This could be clinically relevant as the arteries could serve as landmarks for accurate nerve capture during ultrasound‐guided nerve blockade or ablation. The aim of this cadaveric study was to investigate the anatomical distribution of the DGA, assess the nerves running alongside its branches, and discuss the implications for regional anesthesia and knee pain interventions. Methods We dissected the femoral artery (FA) all along its course to identify the origin of the DGA, from which we carefully dissected all branches, in 27 fresh‐frozen human specimens. Simultaneously, we systematically dissected the nerves supplying the medial aspect of the knee from proximally to distally and identified those running alongside the branches of the DGA. The surrounding anatomical landmarks were identified and measurements were recorded. Results The DGA was found in all specimens, arising from the FA 130.5 ± 17.5 mm (mean ± SD) proximally to the knee joint line. Seven distribution patterns of the DGA were observed. We found three consistent branches from the DGA running alongside their corresponding nerves at the level of the medial aspect of the knee: the artery of the superior‐medial genicular nerve, the artery of the infrapatellar branch of the saphenous nerve, and the saphenous branch of the DGA. Conclusion The consistent arteries and surrounding landmarks found in this study could help to improve the capture of the targeted nerves during ultrasound‐guided interventions.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Anatomical study of the descending genicular artery and implications for image‐guided interventions for knee pain

Fonkoué¹,

Behets²,

Steyaert³

et al. 2020

Clinical Anatomy

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“…Anatomical studies have reported variations in DGA anatomy with isolated origins of the DGA branches from the distal SFA. 20 Although similar variations were not present in the current study, the DGA originated in three patients from the above-knee popliteal artery instead of the distal SFA. The MSGA was the most commonly absent of the medial genicular arteries (present 84.6% of the time) and had the smallest mean diameter (1.2 mm).…”

Section: Medial Compartmentsupporting

confidence: 65%

Angiographic Analysis of the Anatomical Variants in Genicular Artery Embolization

Bagla¹,

Piechowiak²,

Sajan

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

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Purpose: Genicular artery embolization (GAE) has been proposed as a novel technique to treat painful synovitis related to osteoarthritis. An in-depth understanding of the genicular arterial anatomy is crucial to achieve technical success and avoid nontarget-related complications. Given the lack of previous angiographic description, the present study analyzes genicular arterial anatomy and proposes an angiographic classification system. Materials and Methods: Angiographic findings from 41 GAEs performed during two US clinical trials from January 2017 to July 2019 were reviewed to analyze the anatomical details of the following vessels: descending genicular artery (DGA), medial superior genicular artery (MSGA), medial inferior genicular artery (MIGA), lateral superior genicular artery (LSGA), lateral inferior genicular artery (LIGA), and anterior tibial recurrent artery (ATRA). The diameter, angle of origin, and anastomotic pathways were recorded for each vessel. The branching patterns were classified as: medially, M1 (3/3 arteries present) vs M2 (2/3 arteries present); and laterally, L1 (3/3 arteries present) vs L2 (2/3 arteries present). Results: A total of 91 genicular arteries were embolized: DGA (26.4%), MIGA (23.1%), MSGA (22.0%), LIGA (14.3%), and LSGA/ATRA (14.3%). The branching patterns were: medially = M1, 74.4% (n = 29), M2, 25.6% (n = 10); and laterally = L1, 94.9% (n = 37), L2, 5.1% (n = 2). A common origin for MSGA and LSGA was noted in 11 patients (28.2%). A direct DGA origin from the popliteal artery was reported in three patients (7.7%, n = 3). Conclusions: A thorough understanding of the geniculate arterial anatomy is important for maximizing postprocedural pain reduction while minimizing complications, procedure time, and radiation exposure during GAE.

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“…Consequently, the medial genicular branches of the popliteal artery and the DGA branches are of particular importance, as these vessels are common targets for GAE [ 37 ]. Several studies, however, have shown the high degree of variation in genicular vessels and DGA [ 39 , 40 , 42 , 43 , 44 , 45 , 46 , 47 ]. A recent cadaver study by Sighary et al noted that although the most common genicular artery pattern was independent branches of the superior medial (SMGA), superior lateral (SLGA), inferior medial (IMGA), inferior lateral (ILGA), and medial genicular artery (MGA) from the popliteal artery, 72% of cadavers had genicular artery variations [ 39 ].…”

Section: Global Prevalence Natural History Risk Factors Pathophysiolo...mentioning

confidence: 99%

“…Additionally, the same cadaver study noted anatomical variations of the DGA and its muscular (MB), articular (AB), and saphenous branches (SB). Previous plastic surgery literature has created a DGA classification system of seven subtypes [ 47 , 50 ]. Shighary et al, however, utilized a three-subtype classification system of DGA that is more oriented toward GAE.…”

Section: Global Prevalence Natural History Risk Factors Pathophysiolo...mentioning

confidence: 99%

Emerging Targets for the Treatment of Osteoarthritis: New Investigational Methods to Identify Neo-Vessels as Possible Targets for Embolization

et al. 2022

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Osteoarthritis (OA) is the major cause of disability, affecting over 30 million US adults. Continued research into the role of neovascularization and inflammation related to osteoarthritis in large-animal models and human clinical trials is paramount. Recent literature on the pathogenetic model of OA has refocused on low-level inflammation, resulting in joint remodeling. As a result, this has redirected osteoarthritis research toward limiting or treating joint changes associated with persistent synovitis. The overall goal of this review is to better understand the cellular and tissue-specific mechanisms of inflammation in relation to a novel OA treatment modality, Genicular Artery Embolization (GAE). This article also assesses the utility and mechanism of periarticular neovascular embolization for the treatment of OA with a particular emphasis on the balance between pro-angiogenic and anti-angiogenic cytokines, inflammatory biomarkers, and imaging changes.

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Descending genicular artery. Branching patterns and measuring parameters: A systematic review and meta-analysis of several anatomical studies

Cited by 19 publications

References 43 publications

Anatomical study of the descending genicular artery and implications for image‐guided interventions for knee pain

Anatomical study of the descending genicular artery and implications for image‐guided interventions for knee pain

Angiographic Analysis of the Anatomical Variants in Genicular Artery Embolization

Emerging Targets for the Treatment of Osteoarthritis: New Investigational Methods to Identify Neo-Vessels as Possible Targets for Embolization

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