CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2019; 04(01): e24-e28
DOI: 10.1055/s-0039-1688763
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Rheumatoid Lymphedema Successfully Treated with Lymphaticovenular Anastomosis: A Case Report

Yuko Ichinose
1  Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
,
Yoshichika Yasunaga
1  Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
2  Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Japan
,
Shunsuke Yuzuriha
1  Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
› Author Affiliations
Further Information

Publication History

06 November 2018

19 January 2019

Publication Date:
08 May 2019 (online)

  

Abstract

Background A 76-year-old woman presented with rheumatoid lymphedema (RL) distal to the left elbow after 20 years of affliction with rheumatoid arthritis (RA). Although the RA was controlled by medication, the patient could not receive full-scale compression therapy for her edema with a medium-pressure compression sleeve (pressure: 20–25 mm Hg) due to hand dysfunction caused by long-term RA.

Methods Lymphaticovenular anastomosis (LVA) was performed after compression therapy with a low-pressure sleeve (14–18 mm Hg) proved ineffective for edema relief. Two anastomoses were created in a side-to-end fashion at the cubital fossa.

Results The edema improved rapidly after LVA and was maintained with a low-pressure compression sleeve.

Conclusion LVA represents a treatment option for remaining RL in RA treatment. As some RL patients are ineligible for full-scale compression therapy due to hand dysfunction caused by RA, LVA may help to reduce RL and enable edema management using a low-pressure compression garment without concern for hand dysfunction.

Financial Disclosure

The authors have nothing to disclose.