Impaired lymphatic function recovered after great saphenous vein stripping in patients with varicose vein: Venodynamic and lymphodynamic results Minoru.

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Impaired lymphatic function recovered after great saphenous vein stripping in patients with varicose vein: Venodynamic and lymphodynamic results Minoru Suzuki, MD, Naoki Unno, MD, Naoto Yamamoto, MD, Motohiro Nishiyama, MD, Daisuke Sagara, MD, Hiroki Tanaka, MD, Yuuki Mano, MD, Hiroyuki Konno, MD Journal of Vascular Surgery Volume 50, Issue 5, Pages 1085-1091 (November 2009) DOI: 10.1016/j.jvs.2009.06.003 Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 1 Preoperative indocyanine green (ICG) fluorescence lymphography in a patient with varicose veins: Sequential transition of ICG dye in lymph vessel was observed. The interval ICG dye reached the level of midpoint of the patella was measured as transit time (TT). Journal of Vascular Surgery 2009 50, 1085-1091DOI: (10.1016/j.jvs.2009.06.003) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 2 Movement of indocyanine green (ICG) fluorescence images in a patient with varicose vein. A, A large varicose vein cluster is present in the calf below the knee. ICG fluorescence image moved from the arrow point to the dotted arrow point. B and C, ICG fluorescence images. Arrows indicate the most advancing ICG dye in lymph vessel. In this case, ICG movement was interrupted just below the varicose vein cluster. It took about 5 minutes for the ICG dye crossing over the varicose vein cluster (from the arrow point [B] to the dotted arrow point [C]). Journal of Vascular Surgery 2009 50, 1085-1091DOI: (10.1016/j.jvs.2009.06.003) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 3 A and B, Preoperative venous hemodynamics (venous volume [VV] and venous filling index [VFI]) measured with air plethysmography and clinical severity (CEAP) before surgical treatment. C, Preoperative lymphodynamics (transit time [TT]) measured with indocyanine green (ICG) fluorescence lymphography (TT) and clinical severity (CEAP). *P < .05. Journal of Vascular Surgery 2009 50, 1085-1091DOI: (10.1016/j.jvs.2009.06.003) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 4 Linear regression analysis between transit time (TT) in indocyanine green (ICG) fluorescence lymphography and venous volume (VV). Venous filling index (VFI) in air plethysmography in patients with varicose vein. Journal of Vascular Surgery 2009 50, 1085-1091DOI: (10.1016/j.jvs.2009.06.003) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 5 Box and whiskers plots showing Venous Clinical Severity Score (VCSS). At 6 months after surgical treatment, VCSS significantly improved in patients with varicose vein. Journal of Vascular Surgery 2009 50, 1085-1091DOI: (10.1016/j.jvs.2009.06.003) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 6 A and B, Changes in venous hemodynamics (venous volume [VV] and venous filling index [VFI]) measured with air plethysmography at 6 months after the surgical treatment. C, Changes in lymphodynamics (TT) measured with indocyanine green (ICG) fluorescence lymphography at 6 months after the surgical treatment. *P < .05. Journal of Vascular Surgery 2009 50, 1085-1091DOI: (10.1016/j.jvs.2009.06.003) Copyright © 2009 Society for Vascular Surgery Terms and Conditions