Ultra‐high frequency ultrasound preoperative planning of the rerouting method for lymphaticovenular anastomosis in incisions devoid of vein

Visconti, Giuseppe; Bianchi, Alessandro; Hayashi, Akitatsu; Salgarello, Marzia

doi:10.1002/micr.30600

Cited by 15 publications

(16 citation statements)

References 5 publications

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“…72 Another study 73 analyzed 10 patients affected by refractory peripheral lymphedema before lymphaticovenular anastomosis. Moreover, Visconti et al 74 evaluated the role of UHFUS in lymphatic surgery in patients eligible for supermicrosurgical lymphaticovenular anastomosis.…”

Section: Resultsmentioning

confidence: 99%

“…At present, UHFUS is employed for dermatological, vascular, musculoskeletal, intraoral, and small parts applications. 10 -75 The aim of the present research is to provide a review of current clinical literature on the potential applications of UHFUS in order to discuss its role in diverse clinical settings.…”

Section: Introductionmentioning

confidence: 99%

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Ultra-High Frequency Ultrasound, A Promising Diagnostic Technique: Review of the Literature and Single-Center Experience

et al. 2020

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Objectives: Ultra-high frequency ultrasonography (UHFUS) is a recently introduced diagnostic technique which finds several applications in diverse clinical fields. The range of frequencies between 30 and 100 MHz allows for high spatial resolution imaging of superficial structures, making this technique suitable for the imaging of skin, blood vessels, musculoskeletal anatomy, oral mucosa, and small parts. However, the current clinical applications of UHFUS have never been analyzed in a consistent multidisciplinary manner. The aim of this study is to revise and discuss the current applications of UHFUS in different aspects of research and clinical practice, as well as to provide some examples of the current work-in-progress carried out in our center. Materials and Methods: A literature search was performed in order to retrieve articles reporting the applications of UHFUS both in research and in clinical settings. Inclusion criteria were the use of frequencies above 30 MHz and study design conducted in vivo on human subjects. Results: In total 66 articles were retrieved. The majority of the articles focused on dermatological and vascular applications, although musculoskeletal and intraoral applications are emerging fields of use. We also describe our experience in the use of UHFUS as a valuable diagnostic support in the fields of dermatology, rheumatology, oral medicine, and musculoskeletal anatomy. Conclusion: Ultra-high frequency ultrasonography application involves an increasing number of medical fields. The high spatial resolution and the superb image quality achievable allow to foresee a wider use of this novel technique, which has the potential to bring innovation in diagnostic imaging.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultra-High Frequency Ultrasound, A Promising Diagnostic Technique: Review of the Literature and Single-Center Experience

et al. 2020

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“…However, ICG lymphography cannot visualize lymphatic flow in the deep layer of subcutaneous tissue, or one that is masked beneath dermal backflow patterns, particularly in stardust and diffuse patterns [29]. Ultrasonography can detect the lymphatic vessels even in regions with dermal backflow patterns [30][31][32][33]. Ultrasonography provides a roadmap for surgeons when performing LVA.…”

Section: Discussionmentioning

confidence: 99%

Additional Lymphaticovenular Anastomosis on the Posterior Side for Treatment of Primary Lower Extremity Lymphedema

Hayashi

Visconti

Yang

et al. 2022

JCM

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The efficacy of lymphaticovenular anastomosis (LVA) for the treatment of primary lymphedema has been reported. Previous research suggested the efficacy of LVA on the anterior side of the lower limb, but no research has yet underlined the effectiveness of LVA on the posterior side. In the present study, we aimed to investigate the efficacy of LVA on the posterior side of the lower leg for treatment of primary lymphedema, i.e., whether further improvement of primary lower extremity lymphedema could be expected by performing LVA on the posterior side of the lower limb in addition to the LVA on the anterior side, which is usually performed. Forty-five patients with primary lower extremity lymphedema who underwent LVA twice between March 2018 and September 2020 were retrospectively investigated. Patients were classified into two groups: those who underwent LVA on the posterior side in the second operation (PoLVA group) and those who underwent LVA on the medial and anterior sides again in the second operation (MeLVA group). All patients underwent LVA on the medial and anterior sides in the first operation, but no sufficient improvement was observed. The following factors in the second operation were compared between the two groups: skin incision length, the number of anastomoses, the diameters of the lymphatic vessels, the time required for the dissection of the lymphatic vessels and veins and the reduction in volume. LVA resulted in 227 anastomoses (106 anastomoses in the PoLVA group and 121 anastomoses in the MeLVA group) in 26 patients with primary lymphedema of the lower extremities in two surgeries. The reduction in lower extremity lymphedema index was significantly greater in the PoLVA group than that in the MeLVA group (10.5 ± 4.5 vs. 5.5 ± 3.6; p = 0.008), and the number of anastomoses in the PoLVA group was significantly lower than that in the MeLVA group (3.5 ± 0.6 vs. 4.6 ± 1.0; p = 0.038). LVA on the posterior side subsequent to LVA on the medial and anterior sides resulted in the further improvement of primary lower extremity lymphedema with fewer numbers of anastomoses.

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“…Visconti et al reported usefulness of UHFUS for helping the surgeon to know all those information before the surgery. 18 They found the venule rerouting a simple and effective method to overcome the unfavorable situation of incision devoid of vein in LVA surgery. This method also allows optimizing the surgical scars, which are kept to minimum, that is advantageous under both a functional and a cosmetic point-of-view.…”

Section: A Review Of Current Uhfus Applications In Reconstructive Supermicrosurgerymentioning

confidence: 99%

Recent Advances in Ultrasound Technology: Ultra-High Frequency Ultrasound for Reconstructive Supermicrosurgery

Hayashi

Visconti

Giacalone

et al. 2021

J Reconstr Microsurg

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Background Currently, microsurgeons are in the era of supermicrosurgery and perforator flap reconstruction. As these reconstructions frequently utilize vessels that are smaller than a single millimeter, understanding of location of lymphatic vessels and perforator anatomy preoperatively is essential. To change with the times, the role of ultrasound has changed from just an adjunct to primary imaging of the choice in reconstructive supermicrosurgery. Recently, a novel ultrasonographic technique involving the use of ultra-high frequency ultrasound (UHFUS) frequencies has entered the scene, and appears a promising tool in surgical planning. Methods The literatures on the applications of UHFUS in reconstructive supermicrosurgery were retrieved and reviewed from more than 60 literatures have been published on the surgical applications of UHFUS. Results Nine studies were retrieved from the literature on the applications of UHFUS in reconstructive supermicrosurgery. The articles report both application for lymphatic surgery and perforator flaps. Conclusions UHFUS application involves an increasing number of reconstructive supermicrosurgery field. UHFUS is a valuable and powerful tool for any reconstructive surgeons who are interested in performing supermicrosurgery.

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Ultra‐high frequency ultrasound preoperative planning of the rerouting method for lymphaticovenular anastomosis in incisions devoid of vein

Cited by 15 publications

References 5 publications

Ultra-High Frequency Ultrasound, A Promising Diagnostic Technique: Review of the Literature and Single-Center Experience

Ultra-High Frequency Ultrasound, A Promising Diagnostic Technique: Review of the Literature and Single-Center Experience

Additional Lymphaticovenular Anastomosis on the Posterior Side for Treatment of Primary Lower Extremity Lymphedema

Recent Advances in Ultrasound Technology: Ultra-High Frequency Ultrasound for Reconstructive Supermicrosurgery

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