Genicular collateral arterial circulation is required for perfusion of the lower leg should the superficial femoral artery (SFA) become obstructed by trauma or disease. When describing the anatomy, textbooks only provide a schematic representation of the genicular collateral circulation and suggest that the descending branch of the lateral circumflex artery (DBLCFA) plays a critical role. The DBLCFA may be removed for bypass and reconstructive surgeries; therefore, a sound anatomical description of this artery is essential. This study combines dissection with 3D reconstruction to describe the anatomy of the DBLCFA and to provide a morphological description of its involvement in the genicular anastomosis. Arterial anatomy of ten cadaveric lower limbs was dissected from the inguinal ligament to the level of the tibial tubercle. Furthermore, a 3D model of the anatomy was created using AMIRA and OSIRIX. The origin of the DBLCFA was found to be variable and the artery should be renamed since it does not always originate from the lateral circumflex femoral artery (LCFA). The results showed collateral circulation at the knee is also variable: continuous communicating vessel (1/3); possible communication via capillaries (1/2): no evident communication (1/5). There is anatomical evidence that LDAT contributes to a collateral pathway should the femoropopliteal segment become occluded; its removal is not recommended. LDAT may provide a route for infusion of growth factors or placement of a stent in situations of acute trauma to the SFA that is not bypassable by traditional surgery.
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