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Lymphaticovenous Anastomosis for Age-Related Lymphedema

Authors :
Shuhei Yoshida
Isao Koshima
Hirofumi Imai
Solji Roh
Toshiro Mese
Toshio Uchiki
Ayano Sasaki
Shogo Nagamatsu
Source :
Journal of Clinical Medicine, Vol 10, Iss 21, p 5129 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

Introduction: Primary lymphedema is usually caused by intrinsic disruption or genetic damage to the lymphatics but may also be the result of age-related deterioration of the lymphatics. The aims of this study were to determine the characteristics of age-related lymphedema and to assess the effectiveness of lymphaticovenous anastomosis (LVA) in its treatment. Methods: Eighty-six patients with primary lymphedema affecting 150 lower limbs were divided into three groups according to whether the age of onset was younger than 35 years, 35–64 years, or 65 years or older. Indocyanine green (ICG) lymphography was performed, followed by LVA surgery. ICG lymphography images were visually classified according to whether the pattern was linear, low enhancement (LE), distal dermal backflow (dDB), or extended dermal backflow (eDB). The lower extremity lymphedema (LEL) index score was calculated before and after LVA. Lymphatic vessel diameter and detection rates were also recorded. Results: In the ≥65 group, the lymphedema was bilateral in 54 patients and unilateral in 1 patient. There was statistically significant deterioration in the LEL index score with progression from the linear, LE, dDB through to the eDB pattern in the ≥65 group. The lymphatic vessel diameter was significantly greater in the ≥65 group. The rate of improvement was highest in the ≥65 group. Conclusion: Age-related lymphedema was bilateral and deterioration started distally. The lymphatic vessels in patients with age-related lymphedema tended to be ectatic, which is advantageous for LVA and may increase the improvement rate.

Details

Language :
English
ISSN :
20770383
Volume :
10
Issue :
21
Database :
Directory of Open Access Journals
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.00d7b768fa0b4a728cacf610f61e5340
Document Type :
article
Full Text :
https://doi.org/10.3390/jcm10215129