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Figure 1. An illustrative case of a 63-year-old woman with bilateral lower extremity lymphedema who underwent perioperative
reduction treatment following LVA. (A) 1 month before LVA; (B) 1 year after LVA for the right lower extremity. A remarkable
improvement of edema in the right lower extremity was noted. LVA: Lymphaticovenular anastomosis.
Figure 2. Comparison of lymphoscintigraphy before and after the treatment. (A) 1 month before LVA; (B) 6 months after LVA. Note
that the dermal backflow over the right lower leg and the thigh diminished and the lymphatic pathways became distinct after LVA
followed by perioperative reduction treatment. LVA: Lymphaticovenular anastomosis.
reduced lymphatic pressure, which usually deteriorates in lymphedema in the first place. According to a
[21]
systematic review conducted by Tourani et al. , the overall long-term patency rate of LVA was
discouraging in animal studies due to the gradual decline of the pressure gradient across the anastomosis
