Retrograde lymph flow in the lymphatic vessels in limb lymphedema

Mackie, Helen; Suami, Hiroo; Thompson, Belinda; Ngo, Quan; Heydon-White, Asha; Blackwell, Robbie; Koelmeyer, Louise

doi:10.1016/j.jvsv.2022.04.017

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…Multiple articles used ICG lymphography to observe change in lymphatic drainage to diagnose lymphedema (n = 13) 1,2,38,42,55,64,66,75,76,81,84,85,89. Others identified and described altered lymphatic drainage patterns in limb (n = 13)16,35,39–41,56,61,65,67,68,70,72,83 and breast lymphedema (n = 1)51 for lymphedema diagnosis. One retrospective cohort study described use of ICG lymphography to identify lymphedema of unknown origin and proposed links to age-related change 89.…”

Section: Resultsmentioning

confidence: 99%

Indocyanine Green Lymphography in Conservative Lymphedema Therapy: A Scoping Review

Trevethan,

Patterson,

Doig

et al. 2023

Rehabilitation Oncology

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Background: There is great potential but seemingly limited use of indocyanine green (ICG) lymphography to influence conservative lymphedema therapy clinical practice. This scoping review aimed to map existing evidence for ICG lymphography relating to conservative lymphedema therapy. Methods: A 6-staged scoping review framework of Arksey and O'Malley was used to guide the study. Protocol development included key stakeholder consultation. Searches were conducted in 5 databases with specialist librarian support. A 2-phase selection process undertaken by 2 researchers identified studies for inclusion. Conflicts were resolved by consensus. A subsequent 3-phase data extraction and quality appraisal process occurred. Key findings were presented in a descriptive numerical summary. Results: A total of 6316 records were identified, yielding 162 articles for inclusion. Categorization was made according to article type and purpose of ICG lymphography including lymphedema assessment (diagnosis and staging) and/or conservative therapy. Seventy-six empirical research articles with detailed reference to ICG lymphography were explored further. Conclusion: Current published research about ICG lymphography in conservative lymphedema therapy describes support for its use in lymphedema diagnosis, and proposes staging systems for lymphedema severity. Despite existing work, further exploration of effect on conservative therapy planning, clinical, and patient outcomes is necessary to consider future translation to clinical practice.

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Section: Resultsmentioning

confidence: 99%

Indocyanine Green Lymphography in Conservative Lymphedema Therapy: A Scoping Review

Trevethan,

Patterson,

Doig

et al. 2023

Rehabilitation Oncology

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“…Regarding this topic, recently, some controversies have been raised regarding the effects of retrograde anastomoses, as highlighted by the work of Yang et al 27) and by the work of Mackie et al 28) , although larger studies will be needed to assess the impact of retrograde anastomoses on LVA outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, because of the recent increase in doubts regarding the beneficial effects of retrograde flow anastomosis in lymphedema reduction 27,28) , further studies are required to assess the impact of retrograde flow bypass on the results of sLVA.…”

Section: Discussionmentioning

confidence: 99%

Fundamentals for Supermicrosurgical Lymphaticovenular Anastomosis: Part 1 Comprehensive Review of Anastomosis Techniques and Proposal for a Flowchart Algorithm

Gabriele,

Benedetti,

Cascino

et al. 2024

JPRS

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Supermicrosurgical lymphaticovenular anastomosis represents an established procedure for lymphedema treatment, the effectiveness of which has been well documented in international literature. Nevertheless, currently, no standards for supermicrosurgical lymphaticovenular anastomosis have been established regarding the type, location, and number of anastomoses so that the approach to surgical scenarios still depends on the surgeons' preference and ability. A comprehensive literature search for articles involving supermicrosurgical lymphaticovenular anastomosis techniques was performed on the PubMed/Medline/SCOPUS databases. Results, including the names of the technique and their characteristics, such as indications, surgical time, and configuration of the vessels, are reported. Each technique included was then performed five times, and for each of them, patency was tested intraoperatively and 30 days after surgery. Moreover, an efficacy score was assigned, taking into consideration the number of lymphatic vessels anastomosed, the average time for anastomosis, and the difficulty of each technique. A total of 148 articles resulted from the literature search. In total, 16 papers met the criteria for inclusion as defined in the methods and were included in the review as a "supermicrosurgical lymphaticovenular anastomosis technique." Efficacy scores ranged from 0.21 to 1, intraoperative patency ranged from 80% to 100%, and the 30-days patency test ranged from 60% to 100%. To perform effective anastomoses and aim to maximize the results of supermicrosurgical lymphaticovenular anastomosis, a modern microsurgeon should be trained to recognize and manage the most common vessel configurations, performing the most adequate one of the several techniques described. Further studies are required to validate and compare the use of the supermicrosurgical lymphaticovenular anastomosis techniques reviewed.

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“…This technical trick takes advantage of the anatomic fact that superficial lymphatic anatomy loosely approximates that of superficial venous anatomy. In the unfortunate scenario of failure to image both the lymph vessels and the superficial veins, the lymph vessels can still be uncovered with the so-called "blind/anatomic" approach, based on a detailed knowledge of the superficial lymphatic system -how the lymph vessels are distinctly clustered in certain anatomic segments [5,8] .…”

Section: Discussionmentioning

confidence: 99%

“…In keeping with the lymphosome theory, multiple, distal-level injection techniques have been described by some authors to include more lymhosomes [8,[10][11][12] . However, within the length of a given lymphosome, there can be segments of unfavorable flow.…”

Section: Discussionmentioning

confidence: 99%

Distal- to- proximal sequential ICG injection technique (DOPSIT) for lymphatic vessels mapping

Chen¹,

Pandey²

2023

Plast Aesthet Res

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Supermicrosurgical lymphaticovenular anastomosis (LVA) is the most sought-after procedure among lymphedema patients. However, the same enthusiasm is currently not shared among lymphedema surgeons due to the lackluster results of LVA. The common unfavorable experience with this famed procedure is at least partially caused by the difficulty in finding the lymph vessels. We share our time-tested indocyanine green-based lymph vessel mapping technique, which has helped us establish LVA as our procedure for all fluid-predominant lymphedema.

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Retrograde lymph flow in the lymphatic vessels in limb lymphedema

Cited by 6 publications

References 22 publications

Indocyanine Green Lymphography in Conservative Lymphedema Therapy: A Scoping Review

Indocyanine Green Lymphography in Conservative Lymphedema Therapy: A Scoping Review

Fundamentals for Supermicrosurgical Lymphaticovenular Anastomosis: Part 1 Comprehensive Review of Anastomosis Techniques and Proposal for a Flowchart Algorithm

Distal- to- proximal sequential ICG injection technique (DOPSIT) for lymphatic vessels mapping

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