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Split Intravascular Stents for Side-to-End Lymphaticovenular Anastomosis

Yamamoto, Takumi MD; Yoshimatsu, Hidehiko MD; Narushima, Mitsunaga MD; Yamamoto, Nana MD; Koshima, Isao MD

doi: 10.1097/SAP.0b013e318250f0a0
Microsurgery
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Supermicrosurgical lymphaticovenular anastomosis (LVA) is becoming the treatment of choice for compression-refractory lymphedema. Among various types of LVA, side-to-end (S-E) LVA is considered to be the most efficient one, because it can divert bidirectional lymph flows into venous circulation via 1 anastomosis, but is technically difficult. We developed a new technique for safe and easy S-E LVA with modified intravascular stenting (IVaS) method. Different from the original IVaS method, a lymphatic vessel is pierced by an IVaS before creation of a lateral window. The IVaS is cut after window creation and the ends are inserted into the lymphatic vessel and the venule respectively, guiding the course of the needle throughout the S-E anastomosis procedure. This method makes S-E LVA easier without special instruments.

Supplemental Digital Content is available in the text.

From the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Received December 6, 2011, and accepted for publication, after revision, February 17, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Takumi Yamamoto, MD, Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: tyamamoto-tky@umin.ac.jp.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.annalsplasticsurgery.com).

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