Case
Lymphovenous anastomoses on the anteromedial lymphatic bundle in patient with primary lymphedema on the lower leg
PRS Insights 2024
26 March 2026
· 20 min watch
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AUTHOR
Christian Taeger, MD
Specialist for Plastic and Hand Surgery, Private Clinic, Munich, Germany
SUMMARY
Lymphovenous anastomoses on the anteromedial lymphatic bundle in patient with primary lymphedema on the lower leg
This is a case of a 64-year-old man with primary lymphedema on the lower leg. A magnetic resonance lymphangiography (MRL) and the preoperative ICG scan the day before surgery showed no significant lymphatics. The incision was made on the anteromedial lymphatic bundle, where large lymphatics were present, albeit misaligned in a spiral condition. Despite revision, this first anastomosis did not show patency. Subsequently, another vessel was selected, where the procedure went smoothly.
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![A close-up view of surgical tools positioned over a blue surgical suture placed on tissue during a medical procedure.]({"xsmall":"https://www.zeiss.com/content/dam/med-hcp/reference-master/myzeiss/peer-insights/free/p-r-surgery/5320-deep-lva-at-medical-knee-for-stage-1-lymphedema/deep-single-lymphovenous.jpg/_jcr_content/renditions/original.image_file.100.56.file/deep-single-lymphovenous.jpg","small":"https://www.zeiss.com/content/dam/med-hcp/reference-master/myzeiss/peer-insights/free/p-r-surgery/5320-deep-lva-at-medical-knee-for-stage-1-lymphedema/deep-single-lymphovenous.jpg/_jcr_content/renditions/original.image_file.360.203.file/deep-single-lymphovenous.jpg","medium":"https://www.zeiss.com/content/dam/med-hcp/reference-master/myzeiss/peer-insights/free/p-r-surgery/5320-deep-lva-at-medical-knee-for-stage-1-lymphedema/deep-single-lymphovenous.jpg/_jcr_content/renditions/original.image_file.768.432.file/deep-single-lymphovenous.jpg","large":"https://www.zeiss.com/content/dam/med-hcp/reference-master/myzeiss/peer-insights/free/p-r-surgery/5320-deep-lva-at-medical-knee-for-stage-1-lymphedema/deep-single-lymphovenous.jpg/_jcr_content/renditions/original.image_file.1024.576.file/deep-single-lymphovenous.jpg","xlarge":"https://www.zeiss.com/content/dam/med-hcp/reference-master/myzeiss/peer-insights/free/p-r-surgery/5320-deep-lva-at-medical-knee-for-stage-1-lymphedema/deep-single-lymphovenous.jpg/_jcr_content/renditions/original.image_file.1280.720.file/deep-single-lymphovenous.jpg","xxlarge":"https://www.zeiss.com/content/dam/med-hcp/reference-master/myzeiss/peer-insights/free/p-r-surgery/5320-deep-lva-at-medical-knee-for-stage-1-lymphedema/deep-single-lymphovenous.jpg/_jcr_content/renditions/original.image_file.1440.810.file/deep-single-lymphovenous.jpg","max":"https://www.zeiss.com/content/dam/med-hcp/reference-master/myzeiss/peer-insights/free/p-r-surgery/5320-deep-lva-at-medical-knee-for-stage-1-lymphedema/deep-single-lymphovenous.jpg/_jcr_content/renditions/original./deep-single-lymphovenous.jpg"})
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