Lymphatic vessel mapping in the upper extremities of a healthy Korean population

Yun Whan Lee, Soo Hyun Lee, Hijin You, Jae A. Jung, Eul Sik Yoon, Deok-Woo Kim

Research output: Contribution to journalArticle

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Abstract

Background Intraoperative indocyanine green (ICG) lymphography can effectively detect functioning lymph vessels in edematous limbs. However, it is sometimes difficult to clearly identify their course in later-stage edematous limbs. For this reason, many surgeons rely on experience when they decide where to make the skin incision to locate the lymphatic vessels. The purpose of this study was to elucidate lymphatic vessel flow patterns in healthy upper extremities in a Korean population and to use these findings as a reference for lymphedema treatment. Methods ICG fluorescence lymphography was performed by injecting 1 mL of ICG into the second web space of the hand. After 4 hours, fluorescence images of lymphatic vessels were obtained with a near-infrared camera, and the lymphatic vessels were marked. Three landmarks were designated: the radial styloid process, the mid-portion of the cubital fossa, and the lower border of the deltopectoral groove. A straight line connecting the points was drawn, and the distance between the connected lines and the marked lymphatic vessels was measured at 8 points. Results There were 30 healthy upper extremities (15 right and 15 left). The average course of the main lymph vessels passed 26.0±11.6 mm dorsal to the styloid process, 5.7±40.7 mm medial to the mid-cubital fossa, and 31.3±26.1 mm medial to the three-quarters point of the upper landmark line. Conclusions The main functioning lymphatic vessel follows the course of the cephalic vein at the forearm level, crosses the mid-cubital point, and travels medially toward the mid-axilla.

Original languageEnglish
Pages (from-to)152-157
Number of pages6
JournalArchives of Plastic Surgery
Volume45
Issue number2
DOIs
Publication statusPublished - 2018 Mar 1

Fingerprint

Lymphatic Vessels
Upper Extremity
Indocyanine Green
Population
Lymphography
Lymph
Extremities
Fluorescence
Axilla
Lymphedema
Forearm
Veins
Hand
Head
Skin

Keywords

  • Indocyanine green
  • Lymphatic vessels
  • Lymphedema
  • Lymphography
  • Upper extremity

ASJC Scopus subject areas

  • Surgery

Cite this

Lymphatic vessel mapping in the upper extremities of a healthy Korean population. / Lee, Yun Whan; Lee, Soo Hyun; You, Hijin; Jung, Jae A.; Yoon, Eul Sik; Kim, Deok-Woo.

In: Archives of Plastic Surgery, Vol. 45, No. 2, 01.03.2018, p. 152-157.

Research output: Contribution to journalArticle

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abstract = "Background Intraoperative indocyanine green (ICG) lymphography can effectively detect functioning lymph vessels in edematous limbs. However, it is sometimes difficult to clearly identify their course in later-stage edematous limbs. For this reason, many surgeons rely on experience when they decide where to make the skin incision to locate the lymphatic vessels. The purpose of this study was to elucidate lymphatic vessel flow patterns in healthy upper extremities in a Korean population and to use these findings as a reference for lymphedema treatment. Methods ICG fluorescence lymphography was performed by injecting 1 mL of ICG into the second web space of the hand. After 4 hours, fluorescence images of lymphatic vessels were obtained with a near-infrared camera, and the lymphatic vessels were marked. Three landmarks were designated: the radial styloid process, the mid-portion of the cubital fossa, and the lower border of the deltopectoral groove. A straight line connecting the points was drawn, and the distance between the connected lines and the marked lymphatic vessels was measured at 8 points. Results There were 30 healthy upper extremities (15 right and 15 left). The average course of the main lymph vessels passed 26.0±11.6 mm dorsal to the styloid process, 5.7±40.7 mm medial to the mid-cubital fossa, and 31.3±26.1 mm medial to the three-quarters point of the upper landmark line. Conclusions The main functioning lymphatic vessel follows the course of the cephalic vein at the forearm level, crosses the mid-cubital point, and travels medially toward the mid-axilla.",
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