Lymphatic Mapping with Contrast-enhanced Ultrasound for Lymphaticovenous Anastomosis Surgery: How We Do It Article Swipe
Samuel Jang
,
Samyd S. Bustos
,
Austin D. Chen
,
Eugene E. Zheng
,
Gina K. Hesley
,
Nathan Brinkman
,
Jill S. Carter
,
Nho V. Tran
,
Vahe Fahradyan
,
Christine U. Lee
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/gox.0000000000005328
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/gox.0000000000005328
Summary: Lymphaticovenous anastomosis (LVA) surgery is an effective surgery for the treatment of lymphedema in the extremities. Indocyanine green lymphography is the reference standard for visualizing lymphatics for LVA surgery, but it has several limitations; most notably, superficial dermal congestion can mask deeper lymphatic vessels. To overcome the limitations, we add contrast-enhanced ultrasound (CEUS) lymphography. We have previously reported that CEUS lymphography can identify lymphatic vessels for LVA surgery that indocyanine green lymphography does not. Here, we describe how we perform CEUS lymphography, including workflow, technique, and documentation. Before informed consent, the patient must be screened for possible adverse reactions to microbubbles. The procedure involves multiple intradermal injections of the microbubble agent at various sites along the extremity. After each injection, imaging for microbubble uptake by lymphatic vessels is performed using an ultrasound scanner with contrast-specific software. We use sulfur hexafluoride lipid-type A microspheres (Lumason/SonoVue; Bracco Suisse SA), but we are investigating the performance of other Food & Drug Administration–approved microbubble agents for CEUS lymphography. Having a systematic approach to marking the skin can mitigate the hindrance of marking over ultrasound coupling gel. Another benefit of CEUS lymphography is the rapid identification of neighboring veins compatible in size and location for anastomosis. We hold regular scheduled multidisciplinary meetings for coordination of care, discussion of outcomes, quality assurance, and ongoing innovation.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/gox.0000000000005328
- OA Status
- gold
- Cited By
- 10
- References
- 10
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4387571423
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4387571423Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1097/gox.0000000000005328Digital Object Identifier
- Title
-
Lymphatic Mapping with Contrast-enhanced Ultrasound for Lymphaticovenous Anastomosis Surgery: How We Do ItWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-10-01Full publication date if available
- Authors
-
Samuel Jang, Samyd S. Bustos, Austin D. Chen, Eugene E. Zheng, Gina K. Hesley, Nathan Brinkman, Jill S. Carter, Nho V. Tran, Vahe Fahradyan, Christine U. LeeList of authors in order
- Landing page
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https://doi.org/10.1097/gox.0000000000005328Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1097/gox.0000000000005328Direct OA link when available
- Concepts
-
Medicine, Microbubbles, Lymphatic system, Contrast-enhanced ultrasound, Indocyanine green, Radiology, Ultrasound, Lymphedema, Anastomosis, Surgery, Pathology, Internal medicine, Breast cancer, CancerTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
10Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 8, 2024: 2Per-year citation counts (last 5 years)
- References (count)
-
10Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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