{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T11:46:26Z","timestamp":1775994386654,"version":"3.50.1"},"reference-count":7,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Lymphovenous anastomosis (LVA) is a cornerstone of physiologic lymphedema surgery. Its success, however, depends on the presence of a functional lymphatic vessel and a suitable reflux\u2010free recipient vein in close proximity. In some cases, anatomical limitations make direct LVA impossible. In these situations, interposition of a vein graft may bridge the anatomical gap and allow completion of a functional bypass. In this case report, we present a case of a 58\u2010year\u2010old woman with secondary left upper\u2010limb lymphedema following mastectomy, axillary lymphadenectomy, and autologous breast reconstruction. Preoperative indocyanine green (ICG) lymphography showed functional lymphatic channels, and LVA was planned. After an initial unsuccessful attempt on the dorsal wrist, a second incision on the volar forearm revealed a suitable lymphatic vessel and superficial vein, allowing an end\u2010to\u2010end anastomosis. Persistent retrograde lymphatic flow led to the creation of a second bypass using a short autologous vein graft, with an end\u2010to\u2010end anastomosis to the lymphatic vessel and an end\u2010to\u2010side anastomosis to the recipient vein. Intraoperative ICG confirmed that both LVAs were patent. The postoperative course was uneventful. At 1\u2010year follow\u2010up, the patient showed a clear reduction in limb swelling, subjective improvement, and less need for compression garments. This case report adds insight demonstrating that an interposition vein graft can enable successful LVA in anatomically challenging situations where a direct lymphaticovenous connection is not feasible. Vein graft\u2010assisted LVA may expand the applicability of supermicrosurgery for lymphedema, though long\u2010term data and larger series are needed to validate its durability and clinical efficacy.<\/jats:p>","DOI":"10.1002\/micr.70209","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:20:53Z","timestamp":1773015653000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vein Graft\u2010Assisted\n                    <scp>LVA<\/scp>\n                    for Challenging Lymphedema Patient: A Case Report"],"prefix":"10.1002","volume":"46","author":[{"given":"Federica","family":"Martini","sequence":"first","affiliation":[{"name":"Plastic Surgery Pyramide, Haus Zur Pyramide  Zurich Switzerland"},{"name":"Department of Plastic Reconstructive and Aesthetic Surgery University of Milan  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-6985","authenticated-orcid":false,"given":"Matteo","family":"Meroni","sequence":"additional","affiliation":[{"name":"Plastic Surgery Pyramide, Haus Zur Pyramide  Zurich Switzerland"},{"name":"Department of Health Sciences and Medicine University of Lucerne  Lucerne Switzerland"},{"name":"Department of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-9140","authenticated-orcid":false,"given":"Mario F.","family":"Scaglioni","sequence":"additional","affiliation":[{"name":"Plastic Surgery Pyramide, Haus Zur Pyramide  Zurich Switzerland"},{"name":"Department of Health Sciences and Medicine University of Lucerne  Lucerne Switzerland"},{"name":"Department of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31829fe12f"},{"issue":"2","key":"e_1_2_7_3_1","first-page":"71","article-title":"Use of Autologous Interposition Vein Graft in Management of Lymphedema: Preliminary Experimental and Clinical Observations","volume":"24","author":"Campisi C.","year":"1991","journal-title":"Lymphology"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.06.076"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000210"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30246"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1538574415614402"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.21037\/tbcr-24-49"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70209","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.70209","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T10:58:34Z","timestamp":1775991514000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.70209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":7,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/micr.70209"],"URL":"https:\/\/doi.org\/10.1002\/micr.70209","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70209"}}