The Anatomy of Genicular Artery Embolization: A Pictorial Essay

Genicular artery embolization (GAE) has emerged as a safe and effective treatment for patients with osteoarthritis-related knee pain and those experiencing recurrent hemarthrosis. With the plethora of positive prospective cohort studies now being built upon by recent and soon-to-be-published randomized trials, this procedure will only continue to grow in popularity, thus necessitating education of the interventional radiology (IR) workforce. As with other IR procedures, a thorough understanding of the anatomy and common variations of the intended treatment target is essential for appropriate preprocedural planning, precise identification of target vessels, and reduction of potential complications during embolization. This pictorial essay aims to delineate the anatomy of the genicular arterial system, including its feeding vessels, tissues supplied, and anastomoses to provide an up-to-date reference of common variants, a systematic approach to complex anatomy, and associated procedural considerations.