Arch Plast Surg.  2018 May;45(3):275-279. 10.5999/aps.2017.01354.

The lateral intercostal artery perforator as an alternative donor vessel for free vascularized lymph node transplantation

• Kwak MS
• Machens HG

• KMID: 2413025
• DOI: http://doi.org/10.5999/aps.2017.01354

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.

Keyword

Lymphedema; Transplantation, autologous; Perforator flap; Microsurgery; Free tissue flaps

MeSH Terms

Arteries*
Extremities
Female
Free Tissue Flaps
Humans
Leg
Lymph Nodes*
Lymphatic System
Lymphedema
Microsurgery
Perforator Flap
Tissue Donors*
Transplantation, Autologous
Uterine Cervical Neoplasms