The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description
Background:. Lymphedema is common after lymphatic damage in cancer treatment, with negative impacts on function and quality of life. Evidence suggests that blood vessel microvasculature is sensitive to irradiation and trauma; however, despite knowledge regarding dedicated mural blood supply to arter...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005547 |
| _version_ | 1797341069162053632 |
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| author | Charlotte L. Bendon, MA(Oxon), BM, BCh Eric Hanssen, PhD Cameron Nowell, MSc Tara Karnezis, BSc, PhD Ramin Shayan, MB BS, PhD, FRACS |
| author_facet | Charlotte L. Bendon, MA(Oxon), BM, BCh Eric Hanssen, PhD Cameron Nowell, MSc Tara Karnezis, BSc, PhD Ramin Shayan, MB BS, PhD, FRACS |
| author_sort | Charlotte L. Bendon, MA(Oxon), BM, BCh |
| collection | DOAJ |
| description | Background:. Lymphedema is common after lymphatic damage in cancer treatment, with negative impacts on function and quality of life. Evidence suggests that blood vessel microvasculature is sensitive to irradiation and trauma; however, despite knowledge regarding dedicated mural blood supply to arteries and veins (vasa vasorum), equivalent blood vessels supplying lymphatics have not been characterized. We studied collecting lymphatics for dedicated mural blood vessels in our series of 500 lymphaticovenous anastomosis procedures for lymphedema, and equivalent controls.
Methods:. Microscopic images of lymphatics from lymphedema and control patients were analyzed for lymphatic wall vascular density. Collecting lymphatics from 20 patients with lymphedema and 10 control patients were sampled for more detailed analysis (podoplanin immunostaining, light/confocal microscopy, microcomputed tomography, and transmission electron microscopy) to assess lymphatic wall ultrastructure and blood supply.
Results:. Analysis revealed elaborate, dense blood microvessel networks associating with lymphatic walls in lymphedema patients and smaller equivalent vessels in controls. These vasa vasora or “arteria lymphatica” were supplied by regular axial blood vessels, parallel to lymphatic microperforators linking dermal and collecting lymphatics. Lymphatic walls were thicker in lymphedema patients than controls, with immunohistochemistry, computed tomography, transmission electron microscopy, and confocal microscopy characterizing abnormal blood vessels (altered appearance, thickened walls, elastin loss, narrow lumina, and fewer red blood cells) on these lymphatic walls.
Conclusions:. Dedicated blood vessels on lymphatics are significantly altered in lymphedema. A better understanding of the role of these vessels may reveal mechanistic clues into lymphedema pathophysiology and technical aspects of lymphedema microsurgery, and suggest potential novel therapeutic targets. |
| first_indexed | 2024-03-08T10:12:31Z |
| format | Article |
| id | doaj.art-40b7e305bcfc46d2b801d960db2243ff |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-08T10:12:31Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-40b7e305bcfc46d2b801d960db2243ff2024-01-29T07:01:16ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-01-01121e554710.1097/GOX.0000000000005547202401000-00052The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical DescriptionCharlotte L. Bendon, MA(Oxon), BM, BCh0Eric Hanssen, PhD1Cameron Nowell, MSc2Tara Karnezis, BSc, PhD3Ramin Shayan, MB BS, PhD, FRACS4From * The O’Brien Institute Department, St Vincent’s Institute for Medical Research, Fitzroy, Victoria, Australia‡ Advanced Microscopy Facility, Bio21 Institute of Molecular Science and Biotechnology, The University of Melbourne, Parkville, Victoria, Australia§ Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, AustraliaFrom * The O’Brien Institute Department, St Vincent’s Institute for Medical Research, Fitzroy, Victoria, AustraliaFrom * The O’Brien Institute Department, St Vincent’s Institute for Medical Research, Fitzroy, Victoria, AustraliaBackground:. Lymphedema is common after lymphatic damage in cancer treatment, with negative impacts on function and quality of life. Evidence suggests that blood vessel microvasculature is sensitive to irradiation and trauma; however, despite knowledge regarding dedicated mural blood supply to arteries and veins (vasa vasorum), equivalent blood vessels supplying lymphatics have not been characterized. We studied collecting lymphatics for dedicated mural blood vessels in our series of 500 lymphaticovenous anastomosis procedures for lymphedema, and equivalent controls. Methods:. Microscopic images of lymphatics from lymphedema and control patients were analyzed for lymphatic wall vascular density. Collecting lymphatics from 20 patients with lymphedema and 10 control patients were sampled for more detailed analysis (podoplanin immunostaining, light/confocal microscopy, microcomputed tomography, and transmission electron microscopy) to assess lymphatic wall ultrastructure and blood supply. Results:. Analysis revealed elaborate, dense blood microvessel networks associating with lymphatic walls in lymphedema patients and smaller equivalent vessels in controls. These vasa vasora or “arteria lymphatica” were supplied by regular axial blood vessels, parallel to lymphatic microperforators linking dermal and collecting lymphatics. Lymphatic walls were thicker in lymphedema patients than controls, with immunohistochemistry, computed tomography, transmission electron microscopy, and confocal microscopy characterizing abnormal blood vessels (altered appearance, thickened walls, elastin loss, narrow lumina, and fewer red blood cells) on these lymphatic walls. Conclusions:. Dedicated blood vessels on lymphatics are significantly altered in lymphedema. A better understanding of the role of these vessels may reveal mechanistic clues into lymphedema pathophysiology and technical aspects of lymphedema microsurgery, and suggest potential novel therapeutic targets.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005547 |
| spellingShingle | Charlotte L. Bendon, MA(Oxon), BM, BCh Eric Hanssen, PhD Cameron Nowell, MSc Tara Karnezis, BSc, PhD Ramin Shayan, MB BS, PhD, FRACS The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description Plastic and Reconstructive Surgery, Global Open |
| title | The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description |
| title_full | The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description |
| title_fullStr | The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description |
| title_full_unstemmed | The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description |
| title_short | The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description |
| title_sort | arteria lymphatica and lymphatic microperforators a dedicated blood supply to collecting lymphatics and their potential implications in lymphedema anatomical description |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005547 |
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