Classification of Genicular Artery Anatomic Variants Using Intraoperative Cone-Beam Computed Tomography

Purpose Genicular artery embolization (GAE) is a new treatment option for symptomatic knee osteoarthritis. Genicular arterial anatomy is complex with limited published reports. This study describes the genicular artery anatomy utilizing intraprocedural cone-beam computed tomography (CBCT) during GAE...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2023-05, Vol.46 (5), p.628-634
Main Authors: Callese, Tyler E., Cusumano, Lucas, Redwood, Karen D., Genshaft, Scott, Plotnik, Adam, Stewart, Jessica, Padia, Siddharth A.
Format: Article
Language:English
Subjects:
Anatomy
Arteries
Cardiology
Clinical Investigation
Computed tomography
Cone classifiers
Cone-Beam Computed Tomography
Embolization
Humans
Imaging
Knee - blood supply
Lower Extremity
Medicine
Medicine & Public Health
Nuclear Medicine
Osteoarthritis
Popliteal Artery
Radiology
Retrospective Studies
Review boards
Risk reduction
Tomography
Ultrasound
Veins & arteries
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Summary:Purpose Genicular artery embolization (GAE) is a new treatment option for symptomatic knee osteoarthritis. Genicular arterial anatomy is complex with limited published reports. This study describes the genicular artery anatomy utilizing intraprocedural cone-beam computed tomography (CBCT) during GAE. Materials and Methods This retrospective single-center study was approved by the institutional review board. All patients who underwent GAE between May 2018 and April 2022 were reviewed. Patients with a technically adequate CBCT were included in the analysis. CBCTs were analyzed to determine the presence, course, and branching patterns of the genicular arteries. Results A total of 222 patients underwent GAE and 205 (92%) were included for analysis. The descending genicular artery was present in 197 (96%) CBCTs with two branches in 152 (77%). The superior medial genicular artery (SMGA) was present in 186 (91%), superior lateral genicular artery (SLGA) in 203 (99%), inferior medial genicular artery (IMGA) in 195 (95%), inferior lateral genicular artery (ILGA) in 196 (95%), and median genicular artery (MGA) in 200 (97%). Four unique branching patterns were identified: common origin of SLGA and MGA (115, 56%), unique origins (45, 22%), trifurcation of SLGA, SMGA, and MGA (32, 15.5%), and common origin of SMGA and MGA (12, 6%). The recurrent ascending tibial was identified in 156 (76%) CBCTs and superior patellar artery in 175 (85%) CBCTs. Conclusion Genicular artery anatomy is complex with numerous common variants. CBCT is a powerful adjunct in GAE to rapidly identify target vessels for embolization and potentially decrease the risk of nontarget embolization.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-023-03411-3