Topics

Topic

design image
Descending genicular artery (Saphenous branch)

The descending genicular artery is a slender but important branch of the femoral artery. It arises just proximal to the adductor hiatus and descends toward the medial knee. Its saphenous branch follows the saphenous nerve and supplies cutaneous and periarticular structures around the medial knee and leg.

The artery is clinically significant in knee vascular supply, surgical approaches around the adductor canal and knee, and in imaging for trauma, vascular disease, or preoperative planning.

Synonyms

  • Highest genicular artery

  • Superior medial genicular artery (older terminology, though distinct)

  • Saphenous artery branch of descending genicular artery

Origin, Course, and Insertion

  • Origin: Arises from the femoral artery just proximal to the adductor hiatus

  • Course:

    • Passes medially across the adductor canal

    • The saphenous branch pierces the adductor canal wall with the saphenous nerve

    • Descends with the saphenous nerve along the medial side of the knee

  • Distribution: Supplies skin of the medial knee, subcutaneous tissue, periarticular vessels, and participates in collateral circulation around the knee

Branches

  • Saphenous branch: Runs with the saphenous nerve, supplies skin and subcutaneous tissue of the medial knee and proximal leg

  • Articular branch: Contributes to the periarticular genicular anastomosis around the knee joint

Relations

  • Anteriorly: Vastus medialis muscle

  • Posteriorly: Adductor magnus and adductor canal structures

  • Medially: Saphenous nerve (close companion of its saphenous branch)

  • Laterally: Femoral artery and vein (at origin)

  • Distally: Medial knee joint capsule and periarticular vascular network

Function

  • Provides vascular supply to the medial knee skin and capsule

  • Contributes to the genicular arterial anastomosis, supporting collateral circulation around the knee joint

  • Accompanies the saphenous nerve, providing vascular-nervous bundle support

Clinical Significance

  • Important in knee surgery (arthroplasty, medial approaches) due to its proximity to the saphenous nerve

  • May be injured in trauma or surgical dissection along the medial knee, leading to bleeding or pseudoaneurysm

  • Can be visualized and targeted in angiography for collateral flow evaluation

  • Saphenous branch is relevant for flap surgery and reconstructive procedures of the medial leg

MRI Appearance

T1-weighted images:

  • Vessel lumen normally appears as a flow void (dark linear structure)

  • Surrounding fat provides bright contrast

  • Thrombosis or slow flow may appear as altered intraluminal signal

T2-weighted images:

  • Artery lumen demonstrates flow void (dark signal) if patent

  • Surrounding soft tissues and fat provide contrast

  • Pathology (thrombosis, dissection, hematoma) may show hyperintense signal changes around artery

STIR (Short Tau Inversion Recovery):

  • Vessel lumen remains dark (flow void)

  • Perivascular edema or inflammation appears bright

  • Fat suppressed for better delineation

T1 Fat-Sat Post-Contrast (MR angiography):

  • Vessel enhances brightly after gadolinium administration

  • Demonstrates clear course of artery and its branches

  • Pathology (stenosis, occlusion, pseudoaneurysm) seen as focal narrowing, absence of enhancement, or outpouching

MRA Appearance

  • Descending genicular artery and its saphenous branch appear as enhancing vascular channels extending medially from femoral artery

  • 3D MRA demonstrates collateral contribution to genicular arterial network

  • Useful for mapping vascular supply in knee ischemia, trauma, or surgical planning

CT Appearance

Non-Contrast CT:

  • Vessel is seen as a linear soft tissue density structure

  • Surrounding fat helps visualization

  • Calcified plaques (if present) are seen as hyperdense foci

Post-Contrast CT (CTA):

  • Artery enhances brightly and continuously from its femoral origin to its saphenous branch

  • Branches are well-visualized in arterial phase CTA

  • Pathologies: stenosis, occlusion, pseudoaneurysm, arteriovenous fistula, or active extravasation appear clearly

MRI image

Descending Genicular Artery (Saphenous Branch) axial cross sectional anatomy 3T MRI AI enhanced radiology anatomy image-img-00000-00000

MRI image

Descending Genicular Artery (Saphenous Branch) CORONAL cross sectional anatomy 3T MRI AI enhanced radiology anatomy image-img-00000-00000

Descending Genicular Artery (Saphenous Branch) AXIAL CT IMAGE

Descending Genicular Artery (Saphenous Branch) CT CORONAL IMAGE