ArticleScientific reports2022
A new severity classification of lower limb secondary lymphedema based on lymphatic pathway defects in an indocyanine green fluorescent lymphography study.
Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- A systematic review on imaging and diagnostic modalities for the detection, evaluation, and surgical planning of upper and lower extremity lymphedema.Journal of vascular surgery. Venous and lymphatic disorders · 2026Review
- Article
- A new pneumatic lymphatic drainage device enhancing lymphatic flow in lower limbs with lymphedema: a single-center, single-arm, prospective, open-label, non-randomized, exploratory study.Nagoya journal of medical science · 2025Article
- Usefulness of Four-Point Dermal-Injection Lymphatic Scintigraphy for Lower-Limb Lymphedema.Cureus · 2025Article
- Lower extremity lymphatic flow is associated with diuretic response in acute heart failure.European journal of heart failure · 2025Article
- Lymphatic flow dynamics under exercise load assessed with thoracic duct ultrasonography.Scientific reports · 2025Article
- Article
- Article
- Ultrasound Irradiation as a Candidate Procedure to Improve the Transdermal Drug Delivery to the Tail Edema of a Mouse Model.International journal of molecular sciences · 2024Article
- Magnetic resonance lymphangiography: Establishing normal.Journal of vascular surgery. Venous and lymphatic disorders · 2024Article
- Lower Extremity Lymphatic Flow/Drainage Assessment by Indocyanine Green Fluorescent Lymphography in Heart Failure Patients.JACC. Basic to translational science · 2024Article
- A new lymphography protocol and interpretation principles based on functional lymphatic anatomy in lower limb lymphedema.Anatomical science international · 2024Review
- Fluorescence-guided surgery: comprehensive review.BJS open · 2023Review
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
Most protocols for lymphatic imaging of the lower limb conventionally inject tracer materials only into the interdigital space; however, recent studies indicate that there are four independent lymphatic vessel groups (anteromedial, anterolateral, posteromedial, and posterolateral) in the lower limb. Thus, three additional injection sites are needed for lymphatic imaging of the entire lower limb. We aimed to validate a multiple injection designed protocol and demonstrate its clinical benefits. Overall, 206 lower limbs undergoing indocyanine green fluorescent lymphography with the new injection protocol were registered retrospectively. To assess the influence of predictor variables on the degree of severity, multivariable logistic regression models were used with individual known risk factors. Using a generalized linear model, the area under the curve (AUC) of the conventional clinical model, comprising known severity risk factors, was compared with that of the modified model that included defects in the posterolateral and posteromedial groups. Multivariable logistic regression models showed a significant difference for the posteromedial and posterolateral groups. The AUC of the modified model was significantly improved compared to that of the conventional clinical model. Finding defects in the posteromedial and posterolateral groups is a significant criterion for judging lymphedema severity and introducing a new lymphedema severity classification.
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Registered trials
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