Geniculate Artery Embolization: Role in Knee Hemarthrosis and Osteoarthritis

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

“…GAE requires a fundamental knowledge of knee vascular anatomy, along with its variations, for effectively and safely identifying the embolizing target [ 37 , 38 ]. Three main vessels provide the vascular supply to the knee.…”

“…The descending genicular artery (DGA) branching from the femoral artery supplies the superior knee, the anterior tibial recurrent artery (ATRA) branching from the anterior tibial artery supplies the inferior knee, and the genicular arteries arising from the popliteal artery supply the remainder of the knee joint [ 39 ]. Because the medial aspect of the joint is the weight-bearing portion of the knee, the medial knee joint compartment is more commonly affected by OA than the lateral compartment [ 37 , 40 , 41 ]. 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 ].…”

“…Because the medial aspect of the joint is the weight-bearing portion of the knee, the medial knee joint compartment is more commonly affected by OA than the lateral compartment [ 37 , 40 , 41 ]. 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 ].…”

“…Common origins are also important to consider for minimizing the risk of nontarget embolization. Common trunks involving the MGA are especially important, as nontarget embolization may result in damage to the cruciate ligaments [ 37 , 41 , 43 , 53 ]. O’Grady et al observed three variants of vessels with a common origin of the MGA: the SMGA (5 out of 20 cadavers), SLGA (4 out of 20 cadavers), and both the SMGA and SLGA (1 out of 20) [ 41 ].…”

“…Therapeutic embolization for osteoarthritis has had promising early results [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 57 , 58 ]. Heller et al reviewed the technical success, defined as embolization of at least one target genicular artery, and clinical success of GAE [ 37 ]. According to Heller et al, the technical success of GAE has been reported to range from 84 to 100%, and GAE has shown clinical success based on WOMAC [ 13 , 14 ], KOOS [ 15 , 18 ], and VAS scores [ 13 , 14 , 18 , 57 ].…”