Cadaveric and Angiographic Anatomical Considerations in the Genicular Arterial System: Implications for Genicular Artery Embolisation in Patients with Knee Osteoarthritis

O'Grady, Aiden M.; Welsh, Luke; Gibson, Matthew; Briggs, James; Speirs, Archie; Little, Mark W.

doi:10.1007/s00270-021-02978-z

Cited by 22 publications

(15 citation statements)

References 22 publications

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“…Bagla et al observed a similar adverse event after GAE, with 13 of 20 patients noting skin discoloration that self-resolved within 3 months of GAE [ 14 ]. O’Grady et al and other studies have observed cutaneous supply from the DGA and SLGA [ 41 , 50 , 52 ]. Additionally, unavoidable cutaneous branches are present on the ILGA and IMGA [ 41 ].…”

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

confidence: 93%

“…O’Grady et al and other studies have observed cutaneous supply from the DGA and SLGA [ 41 , 50 , 52 ]. Additionally, unavoidable cutaneous branches are present on the ILGA and IMGA [ 41 ]. Little et al minimized the nontarget embolization of cutaneous arteries by utilizing ice packs to constrict cutaneous vessels temporarily [ 18 ].…”

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

confidence: 93%

“…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 ].…”

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

confidence: 99%

“…Bagla et al observed anastomoses in 26.4% of genicular arteries, with highest rates between the musculoarticular branch of the DGA and the SMGA/SLGA [ 38 ]. Other cadaver studies have observed anastomoses between the DGA and SMGA and between the IMGA and medial sural artery [ 41 ]. Although the clinical impact of these anastomoses was not discussed, Little et al noted the impact vessel anastomoses within the knee vasculature network can have on nontarget embolization [ 18 ].…”

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

confidence: 99%

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

confidence: 93%

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

confidence: 93%

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

confidence: 99%

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

confidence: 99%

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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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“…Compared with investigations on metaphyseal and epiphyseal vasculatures, previous studies on pediatric genicular vessels are much less common 7,9,25 . Based on our findings, there are two transphyseal vessels that seem to be one artery originating from the MGA branch and one vein originating from the MGV tributary in the proximal tibia and distal femur.…”

Section: Normal Morphological Characteristics Of Itcsmentioning

confidence: 94%

Discovery and Characterization of Intercondylar Transphyseal Complexes and their Oncological Significance in Transphyseal Extension of Pediatric Osteosarcoma

Shao

Zhang

et al. 2022

Orthopaedic Surgery

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Objective To explore whether there exist undiscovered transphyseal vasculature‐canal compound structures in immature femurs and tibias, and reveal their potential oncological impact. Methods This investigation was divided into a morphological study and a clinical study. In the morphological part, a new‐identified anatomic structure was investigated by using radiographical, anatomical, and histological methodologies. Twenty‐eight 1‐mm‐slice thickness magnetic resonance images of pediatric knees were generated and 10 pediatric knees were dissected to verify the existence and universality, observe the radiographic and anatomic characteristics, and determined the located region of this structure. Hematoxylin–eosin staining, immunofluorescence, and angiography procedures were performed to illustrate its histological feature, molecular identification, and vascular origination, respectively. In the clinical part, 38 pediatric osteosarcoma patients were enrolled from January 2014 to December 2020. A descriptive clinical study including 13 typical participants was conducted to investigate the oncological significance of this new‐identified structure. Meanwhile, the discrepancy in transphyseal osteosarcoma extension between different physeal regions was evaluated in a cross‐sectional study. Results In the morphological study, we discovered a new‐found vasculature‐canal compound structure, intercondylar transphyseal complex (ITC), which originated from the middle genicular vessels, traversed the whole epiphysis, and breached the intact open physis in the immature proximal tibia or distal femur. The components of ITC included the juxta‐articular, epiphyseal, and transphyseal segments of vessels, the canals that traverse the entire epiphysis and physis and enclosed the vessels, vascular foramina on articular facet and foramina‐covered synovium. Depending on the location, ITCs can be divided into three types: femoral ITC, anterior tibial ITC, and posterior tibial ITC. Clinically, the ITC may facilitate intercondylar transphyseal sarcomatous dissemination without damaging the adjacent physeal cartilage. Compared to bilateral condylar physes, more osteosarcomas transgressed the open growth plates through intercondylar regions in which ITC was located ( P = 0.022). Conclusion As the “gap” on intact open physis, ITC, which is a new‐identified compound structure in intercondylar regions of immature femur or tibia, may promote intercondylar transphyseal tumor extension. Moreover, the identification and characterization of ITC subvert some traditional comprehensions about physis and may provide novel perspectives for pediatric osteosarcomas.

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Genicular artery embolization as a treatment for refractory osteoarthritis related knee pain

Epelboym

Lee

Okuno³

et al. 2022

Skeletal Radiol

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Cadaveric and Angiographic Anatomical Considerations in the Genicular Arterial System: Implications for Genicular Artery Embolisation in Patients with Knee Osteoarthritis

Cited by 22 publications

References 22 publications

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

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

Discovery and Characterization of Intercondylar Transphyseal Complexes and their Oncological Significance in Transphyseal Extension of Pediatric Osteosarcoma

Genicular artery embolization as a treatment for refractory osteoarthritis related knee pain

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