Investigation of the Leg Lymphatic Function in Patients with Leg Acute Venous Thrombosis and in Patients with Leg Post-Thrombotic Syndrome

Cariati, Andrea

doi:10.2174/1877382601003010067

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…Using lymphoscintigraphy, Cariati 21 likewise reported the compensatory effort of increased lymphatic transport in patients with acute venous thrombi as measured by transit times. Using NIRFLI, compensatory lymphatic pumping in rats has been shown to increase after stressing with salt-induced hypertension 23 .…”

Section: Discussionmentioning

confidence: 99%

Lymphatic transport in patients with chronic venous insufficiency and venous leg ulcers following sequential pneumatic compression

Rasmussen

Aldrich

Tan

et al. 2016

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Objective To assess lymphatics in subjects with venous leg ulcers using near-infrared fluorescence lymphatic imaging (NIRFLI) and to assess lymphatic impact of a single session of sequential pneumatic compression (SPC). Background Recent advancements in NIRFLI technology provide opportunities for non-invasive, real-time assessment of lymphatic contribution in the etiology and treatment of ulcers. Methods Following intradermal microdoses of indocyanine green (ICG) as a lymphatic contrast agent, NIRFLI was used in a pilot study to image the lymphatics of 12 subjects with active venous leg ulcers (CEAP C6). The lymphatics were imaged before and after a single session of SPC to assess impact on lymphatic function. Results Baseline imaging showed impaired lymphatic function and bilateral dermal backflow in all subjects with chronic venous insufficiency, even those without ulcer formation in the contralateral limb (C0 and C4 disease). SPC therapy caused proximal movement of ICG away from the active wound in 9 of 12 subjects, as indicated by newly recruited functional lymphatic vessels, emptying of distal lymphatic vessels, or proximal movement of extravascular fluid. Subjects with the longest duration of active ulcers had few visible lymphatic vessels and proximal movement of ICG was not detected after SPC therapy. Conclusions This study provides visible confirmation of lymphatic dysfunction at an early stage in the etiology of venous ulcer formation and demonstrates the potential therapeutic mechanism of SPC therapy in removing excess fluid. The ability of SPC therapy to restore fluid balance through proximal movement of lymph and interstitial fluid may explain its value in hastening venous ulcer healing. Anatomical differences between the lymphatics of longstanding and more recent venous ulcers may have important therapeutic implications.

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Section: Discussionmentioning

confidence: 99%