{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:36:23Z","timestamp":1771482983328,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T00:00:00Z","timestamp":1635638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Primary lymphedema is usually caused by intrinsic disruption or genetic damage to the lymphatics but may also be the result of age-related deterioration of the lymphatics. The aims of this study were to determine the characteristics of age-related lymphedema and to assess the effectiveness of lymphaticovenous anastomosis (LVA) in its treatment. Methods: Eighty-six patients with primary lymphedema affecting 150 lower limbs were divided into three groups according to whether the age of onset was younger than 35 years, 35\u201364 years, or 65 years or older. Indocyanine green (ICG) lymphography was performed, followed by LVA surgery. ICG lymphography images were visually classified according to whether the pattern was linear, low enhancement (LE), distal dermal backflow (dDB), or extended dermal backflow (eDB). The lower extremity lymphedema (LEL) index score was calculated before and after LVA. Lymphatic vessel diameter and detection rates were also recorded. Results: In the \u226565 group, the lymphedema was bilateral in 54 patients and unilateral in 1 patient. There was statistically significant deterioration in the LEL index score with progression from the linear, LE, dDB through to the eDB pattern in the \u226565 group. The lymphatic vessel diameter was significantly greater in the \u226565 group. The rate of improvement was highest in the \u226565 group. Conclusion: Age-related lymphedema was bilateral and deterioration started distally. The lymphatic vessels in patients with age-related lymphedema tended to be ectatic, which is advantageous for LVA and may increase the improvement rate.<\/jats:p>","DOI":"10.3390\/jcm10215129","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T22:21:34Z","timestamp":1635805294000},"page":"5129","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Lymphaticovenous Anastomosis for Age-Related Lymphedema"],"prefix":"10.3390","volume":"10","author":[{"given":"Shuhei","family":"Yoshida","sequence":"first","affiliation":[{"name":"The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isao","family":"Koshima","sequence":"additional","affiliation":[{"name":"The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Imai","sequence":"additional","affiliation":[{"name":"The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solji","family":"Roh","sequence":"additional","affiliation":[{"name":"The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiro","family":"Mese","sequence":"additional","affiliation":[{"name":"The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshio","family":"Uchiki","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 739-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayano","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 739-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shogo","family":"Nagamatsu","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 739-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/0190-9622(93)70078-8","article-title":"Abnormal lymph drainage in patients with chronic venous leg ulcers","volume":"28","author":"Bull","year":"1993","journal-title":"J. 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