Lymphaticovenous Anastomosis for Age-Related Lymphedema

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 effective...

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Autores principales:	Shuhei Yoshida, Isao Koshima, Hirofumi Imai, Solji Roh, Toshiro Mese, Toshio Uchiki, Ayano Sasaki, Shogo Nagamatsu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	lymphedema aging lymphaticovenous anastomosis Medicine R
Acceso en línea:	https://doaj.org/article/00d7b768fa0b4a728cacf610f61e5340
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spelling	oai:doaj.org-article:00d7b768fa0b4a728cacf610f61e53402021-11-11T17:45:39ZLymphaticovenous Anastomosis for Age-Related Lymphedema10.3390/jcm102151292077-0383https://doaj.org/article/00d7b768fa0b4a728cacf610f61e53402021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5129https://doaj.org/toc/2077-0383Introduction: 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.Shuhei YoshidaIsao KoshimaHirofumi ImaiSolji RohToshiro MeseToshio UchikiAyano SasakiShogo NagamatsuMDPI AGarticlelymphedemaaginglymphaticovenous anastomosisMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5129, p 5129 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lymphedema aging lymphaticovenous anastomosis Medicine R
spellingShingle	lymphedema aging lymphaticovenous anastomosis Medicine R Shuhei Yoshida Isao Koshima Hirofumi Imai Solji Roh Toshiro Mese Toshio Uchiki Ayano Sasaki Shogo Nagamatsu Lymphaticovenous Anastomosis for Age-Related Lymphedema
description	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.
format	article
author	Shuhei Yoshida Isao Koshima Hirofumi Imai Solji Roh Toshiro Mese Toshio Uchiki Ayano Sasaki Shogo Nagamatsu
author_facet	Shuhei Yoshida Isao Koshima Hirofumi Imai Solji Roh Toshiro Mese Toshio Uchiki Ayano Sasaki Shogo Nagamatsu
author_sort	Shuhei Yoshida
title	Lymphaticovenous Anastomosis for Age-Related Lymphedema
title_short	Lymphaticovenous Anastomosis for Age-Related Lymphedema
title_full	Lymphaticovenous Anastomosis for Age-Related Lymphedema
title_fullStr	Lymphaticovenous Anastomosis for Age-Related Lymphedema
title_full_unstemmed	Lymphaticovenous Anastomosis for Age-Related Lymphedema
title_sort	lymphaticovenous anastomosis for age-related lymphedema
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/00d7b768fa0b4a728cacf610f61e5340
work_keys_str_mv	AT shuheiyoshida lymphaticovenousanastomosisforagerelatedlymphedema AT isaokoshima lymphaticovenousanastomosisforagerelatedlymphedema AT hirofumiimai lymphaticovenousanastomosisforagerelatedlymphedema AT soljiroh lymphaticovenousanastomosisforagerelatedlymphedema AT toshiromese lymphaticovenousanastomosisforagerelatedlymphedema AT toshiouchiki lymphaticovenousanastomosisforagerelatedlymphedema AT ayanosasaki lymphaticovenousanastomosisforagerelatedlymphedema AT shogonagamatsu lymphaticovenousanastomosisforagerelatedlymphedema
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Lymphaticovenous Anastomosis for Age-Related Lymphedema

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