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Multicentric Angiographic Assessment of the Branching Patterns and Anastomotic Network of the Genicular Arteries,
Arian Taheri Amin1, L M Wilms2, N Steinfort1
1Department of Diagnostic and Interventional Radiology, Medical Faculty, Dusseldorf University, 40225, Dusseldorf, Germany.
Purpose:
To describe the anatomy of the genicular arteries and their anastomoses based on intraprocedural digital subtraction angiography (DSA).
Materials And Methods:
This retrospective, multi-center study reviewed patients who underwent genicular artery embolization (GAE) between January 2019 and December 2023. DSA images were analyzed to assess the anatomy of the genicular arteries and their anastomoses.
Results:
A total of 393 GAEs in 358 patients with minimal to severe knee osteoarthrosis (OA; Kellgren/Lawrence Grade I-IV) were analysed. Anastomoses between genicular branches were observed in all patients. In the medial compartment, anastomoses were identified between the descending genicular artery (DGA) and superior medial genicular artery (SMGA) in 158 GAEs (40%), the DGA and inferior medial genicular artery (IMGA) in 132 GAEs (34%), and the SMGA and IMGA in 64 GAEs (16%). In the lateral compartment, anastomoses were observed between the superior lateral genicular artery (SLGA) and inferior lateral genicular artery (ILGA) in 192 GAEs (49%), the ILGA and anterior tibial recurrent artery (ARTA) in 152 GAEs (39%), and between the SLGA, ILGA and ARTA in 91 GAEs (23%). Anastomoses between the medial and lateral compartments were identified between the DGA and SLGA in 59 GAEs (15%), the DGA and ILGA in 87 GAEs (22%), and the IMGA and ILGA in 94 GAEs (24%). The mean vessel diameter of the anastomoses ranged from 0.2 to 1.1 mm.
Conclusion:
Anastomoses between genicular arteries are frequent and extensive, with diameters exceeding the sizes of particles (100-300 μm) and microcatheters (1.7-2.4F) commonly used in GAE.
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