Preoperative indocyanine green lymphographic planning for dorsal metatarsal vascularized lymph vessel transfer in the treatment of upper extremity lymphedema

Microsurgery ◽  
2021 ◽  
Author(s):  
Pedro Ciudad ◽  
Wei F. Chen
Keyword(s):  
Indocyanine Green ◽  
Upper Extremity ◽  
Lymph Vessel

scholarly journals Lymph Vessel Mapping Using Indocyanine Green Lymphography in the Nonaffected Side of Lower Leg

2020 ◽  
Vol 8 (6) ◽  
pp. e2929
Author(s):  
Kei Kinugawa ◽  
Takashi Nuri ◽  
Hiroyuki Iwanaga ◽  
Yuki Otsuki ◽  
Koichi Ueda
Keyword(s):  
Indocyanine Green ◽  
Lower Leg ◽  
Lymph Vessel

scholarly journals Near-Infrared Imaging of Indocyanine Green Identifies Novel Routes of Lymphatic Drainage from Metacarpophalangeal Joints in Healthy Human Hands

2020 ◽  
Author(s):  
H. Mark Kenney ◽  
Gregory Dieudonne ◽  
Seonghwan Yee ◽  
Jeffrey H. Maki ◽  
Ronald W. Wood ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Upper Extremity ◽  
Near Infrared ◽  
Dorsal Surface ◽  
Lymphatic Drainage ◽  
Antecubital Fossa ◽  
Healthy Human ◽  
Nir Imaging ◽  
Web Space ◽  
Joint Injections

AbstractBackgroundCollecting lymphatic vessel (CLV) dysfunction has been implicated in various diseases, including rheumatoid arthritis (RA). Previous studies in the tumor necrosis factor-transgenic (TNF-Tg) mouse model of inflammatory-erosive arthritis have demonstrated reduced joint-draining CLV contractility that correlates with arthritic severity. Clinically, RA patients with active hand arthritis exhibit significantly reduced lymphatic clearance of the web spaces adjacent to the metacarpophalangeal (MCP) joints and a reduction in total and basilic-associated CLVs on the dorsal surface of the hand by dynamic near-infrared (NIR) imaging of indocyanine green (ICG). In this pilot study, we assessed direct lymphatic drainage from MCP joints, and aimed to visualize the total lymphatic anatomy using novel dual-agent relaxation contrast magnetic resonance lymphography (DARC-MRL) in the upper extremity of healthy human subjects.MethodsTwo healthy male subjects participated in the study. We performed NIR imaging following intra-dermal web space and intra-articular MCP joint injections of ICG to visualize the CLV anatomy on the dorsal surface of the hand and antecubital fossa. Subsequently, we performed conventional or DARC-MRL after intra-dermal web space and intra-articular MCP joint injections of gadolinium to evaluate the total lymphatic anatomy of the upper extremity and compare with NIR-ICG imaging.ResultsNIR-ICG imaging demonstrated that web space and MCP lymphatics drain via distinct CLV tributaries. Web space draining CLVs tended to be associated with the cephalic side of the antecubital fossa, while MCP draining CLVs were localized to the basilic side of the forearm. The DARC-MRL methods used in this study did not adequately nullify the contrast in the blood vessels, and limited gadolinium-filled CLVs could be identified.ConclusionThrough the use of NIR-ICG imaging, we found that MCP joints predominantly drain into basilic CLVs in the forearm, which may explain the reduction in basilic-associated CLVs in the hands of RA patients. In healthy subjects, current DARC-MRL techniques have limited ability in identifying lymphatic structures and further refinement in this technique is necessary.

Visualization of Accessory Lymphatic Pathways in Secondary Upper Extremity Lymphedema Using Indocyanine Green Lymphography

2017 ◽  
Vol 79 (4) ◽  
pp. 393-396 ◽  
Author(s):  
Kensuke Tashiro ◽  
Shuji Yamashita ◽  
Isao Koshima ◽  
Shimpei Miyamoto
Keyword(s):  
Indocyanine Green ◽  
Upper Extremity ◽  
Lymphatic Pathways

scholarly journals The relationship between lymphedema severity and awareness of lymphedema surgery

2021 ◽  
Vol 48 (5) ◽  
pp. 534-542
Author(s):  
Hyun Seung Lee ◽  
Yong Chan Bae ◽  
Su Bong Nam ◽  
Chang Ryul Yi ◽  
Jin A Yoon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Indocyanine Green ◽  
Upper Extremity ◽  
Surgical Techniques ◽  
Cancer Center ◽  
Limited Knowledge ◽  
Early Stages ◽  
Md Anderson ◽  
The Relationship

Background During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients’ awareness of surgical treatment for secondary upper extremity lymphedema (UEL).Methods Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups.Results Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003).Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.

scholarly journals Infrared imaging of lymphatic function in the upper extremity of normal controls and hand transplant recipients via subcutaneous indocyanine green injection

2019 ◽  
Vol 7 ◽  
pp. 205031211986267 ◽  
Author(s):  
Efrain Farias-Cisneros ◽  
Paula M Chilton ◽  
Michelle D Palazzo ◽  
Tuna Ozyurekoglu ◽  
Jay B Hoying ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Upper Extremity ◽  
Chronic Rejection ◽  
Near Infrared ◽  
Infrared Imaging ◽  
Lymphatic Drainage ◽  
Dynamic Imaging ◽  
Transplant Recipients ◽  
Lymphatic Function ◽  
Normal Controls

Objectives: The goal of this study was to define the parameters of movement of indocyanine green in the upper extremity of normal control and hand transplant recipients. The purpose was to establish a non-invasive method of determining the level of lymphatic function in hand transplant recipients. In hand transplantation (and replantation), the deep lymphatic vessels are rarely repaired, resulting in altered lymphatic connections. In most cases, the relatively rapid inosculation of superficial lymphatic networks and drainage via the venous systems results in sufficient interstitial fluid and lymph drainage of the graft to prevent edema. However, our group and others have determined that some transplant recipients demonstrate chronic edema which is associated with lymphatic stasis. In one case, a patient with chronic edema has developed chronic rejection characterized by thinning of the skin, loss of adnexal structures, and fibrosis and contracture of the hand. Methods: Lymphatic function was evaluated by intradermal administration of near-infrared fluorescent dye, indocyanine green, and dynamic imaging with an infrared camera system (LUNA). To date, the assessment of lymphatic drainage in the upper extremity by clearance of indocyanine green dye has been studied primarily in oncology patients with abnormal lymphatic function, making assessment of normal drainage problematic. To establish normal parameters, indocyanine green lymphatic clearance functional tests were performed in a series of normal controls, and subsequently compared with indocyanine green clearance in hand transplant recipients. Results: The results demonstrate varied patterns of lymphatic drainage in the hand transplant patients that partially mimic normal hand lymphatic drainage, but also share characteristics of lymphedema patients defined in other studies. The study revealed significant deceleration of the dye drainage in the allograft of a patient with suspected chronic rejection and edema of the graft. Analysis of other hand transplant recipients revealed differing levels of dye deceleration, often localized at the level of surgical anastomosis. Conclusion: These studies suggest intradermal injection of indocyanine green and near-infrared imaging may be a useful clinical tool to assess adequacy of lymphatic function in hand transplant recipients.

Indocyanine Green–Enhanced Lymphography for Upper Extremity Lymphedema

2011 ◽  
Vol 128 (4) ◽  
pp. 941-947 ◽  
Author(s):  
Takumi Yamamoto ◽  
Nana Yamamoto ◽  
Kentaro Doi ◽  
Azusa Oshima ◽  
Hidehiko Yoshimatsu ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Upper Extremity

scholarly journals Standardizing Upper Extremity Indocyanine Green Lymphography in a Lymphedema Outpatient Setting

2020 ◽  
Vol 8 (9S) ◽  
pp. 127-127
Author(s):  
Itay Wiser ◽  
Andrew L. Weinstein ◽  
Elizabeth Kenworthy ◽  
Babak J. Mehrara ◽  
Joseph H. Dayan
Keyword(s):  
Indocyanine Green ◽  
Upper Extremity ◽  
Outpatient Setting

Enhanced type I photoreaction of indocyanine green via electrostatic-force-driven aggregation

Nanoscale ◽  
2020 ◽  
Vol 12 (17) ◽  
pp. 9517-9523 ◽  
Author(s):  
Huizhen Fan ◽  
Yu Fan ◽  
Wenna Du ◽  
Rui Cai ◽  
Xinshuang Gao ◽  
...  
Keyword(s):  
Mesoporous Silica ◽  
Indocyanine Green ◽  
Electrostatic Force ◽  
Type I ◽  
Positively Charged

ICG forms aggregates in positively charged mesoporous silica, which show an enhanced type I photoreaction pathway.

Combining Values

2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Evaluation Method ◽  
Proximal Phalanx ◽  
Common Error ◽  
The Third ◽  
Whole Person ◽  
Impairment Ratings ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.

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