{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T07:23:41Z","timestamp":1782804221821,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T00:00:00Z","timestamp":1538006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Backgroud<\/jats:title><jats:p>The optimal approaches for concurrent vascular lesions with limb lymphedema are not well established. The purpose of the study was to investigate the outcome of the surgical management of lymphedema with concomitant vascular lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between August 2010 and November 2015, 15 consecutive patients with extremity lymphedema and concomitant vascular lesions treated with vascularized lymph node flaps were reviewed. The patients had vascular interventions discovered during workup for lymphedema surgery. Outcomes were assessed using circumferential difference (CD) and circumferential reduction rate (CRR) at 12\u2010month and final follow\u2010up visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vascular lesions (<jats:italic>n<\/jats:italic>\u2009=\u200915) included proximal arterial occlusion (\n<jats:italic>n<\/jats:italic>\u2009=\u20091), vascular malformation (\n<jats:italic>n<\/jats:italic>\u2009=\u20092), and proximal venous compression\/stenosis (\n<jats:italic>n<\/jats:italic>\u2009=\u200912). Concomitant vascular lesions had an incidence of 15.8% in patients that underwent vascularized lymph node transfers (VLNTs). We had 100% VLNT survival rate and average number of episodes of cellulitis after VLNTs decreased significantly (\n<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The CRR for the below knee\/elbow measurement at 12\u2010months follow\u2010up was significantly higher for patients that underwent vascular intervention for venous lesions before VLNT instead of concurrently or after (23.7% vs 12.2%, \n<jats:italic>P<\/jats:italic>\u2009=\u20090.23). Final mean CRR was 23.7% and 12.2% respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative workup of concomitant vascular lesions is important for lymphedema management. We suggest appropriate vascular intervention should be done prior to VLNT to maximize the short\u2010term and long\u2010term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25237","type":"journal-article","created":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T18:29:57Z","timestamp":1538072997000},"page":"941-952","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Lymphedema and concomitant venous comorbidity in the extremity: Comprehensive evaluation, management strategy, and outcomes"],"prefix":"10.1002","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2676-3044","authenticated-orcid":false,"given":"Neil S.","family":"Sachanandani","sequence":"first","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering Chang Gung Memorial Hospital, College of Medicine, Chang Gung University Taoyuan 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