Geniculate Artery Embolization

Question 1

Etiology of recurrent hemarthrosis after TKA

Answer 1

Etiology not completely understood but reported causes:

1. bleeding of hypertrophic synovium which may be impinged between prothesis components
2. AV fistula
3. pseudoaneurysm
4. PVNS
5. prosthesis complications

Question 2

First best step in hemarthrosis after TKA

Answer 2

Conservative management (33% successful)

• rest
• ice
• elevation
• joint aspiration
• cessation of anticoagulation

Question 3

Other options other than GAE for recurrent hemarthrosis after TKA

Answer 3

• surgery (arthroscopic or open synovectomy)
• ## radiation synovectomy with Y90 injection

Question 4

Targeted arteries for geniculate artery embolization

Answer 4

1. Descending genicular artery
2. Lateral Superior Geniculate Artery
3. Medial Superior Geniculate Artery
4. Lateral Inferior Geniculate Artery
5. Medial Inferior Geniculate Artery
6. Recurrent Branch of the anterior tibial artery

Question 5

most common angiographic findings with recurrent hemarthrosis after TKA

Answer 5

synovial hypervascularity (diffuse periarticular blush) with tortuous or hypertrophied feeding vessels

Question 6

Most common artery embolized during GAE for recurrent hemarthrosis

Answer 6

1. Lateral Superior GA
2. Lateral Inferior GA
3. Descending GA