Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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The lateral intercostal artery perforator as an alternative donor vessel for free vascularized lymph node transplantation

  • Kwak, Min-Seok Daniel (Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich) ;
  • Machens, Hans-Guenther (Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich)
  • Received : 2017.08.16
  • Accepted : 2018.02.08
  • Published : 2018.05.22
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Abstract

Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment. After surgery, the patient reported significant improvement in limb volume and the accompanying symptoms. The limb circumference was reduced by an average of 19.2% at 6 months postoperatively. Despite having a short pedicle and small vessel caliber, the lateral intercostal artery perforator flap can safely be used for VLNT in lymphedema patients with anatomical variants.

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References

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Cited by

  1. Current Concepts in Management of Postmastectomy Lymphedema vol.92, pp.2, 2018, https://doi.org/10.1007/s13126-020-0548-5
  2. Technical Challenges in “Micro” Lymph Node Identification during Vascularized Submental Lymph Node Flap Harvesting vol.8, pp.12, 2018, https://doi.org/10.1097/gox.0000000000003330
  3. Novel Recipient Site for Aesthetic Inset of Vascularized Lymph Node Transfer: Preliminary Report vol.26, pp.2, 2018, https://doi.org/10.12790/ahm.20.0071