Caroline Lilja presents lymphedema research in Canada

Caroline Lilja has been selected to give an oral presentation at the International Lymphedema Framework Conference 2025 in Niagara Falls, Canada.

She will present her study:
"Optimizing Preoperative Planning for Lymphovenous Anastomosis in Breast Cancer-Related Lymphedema."

The research highlights a new approach combining ICG lymphography and ultra-high frequency ultrasound to improve surgical precision and outcomes in lymphedema treatment.

ABSTRACT
Title: "Optimizing Preoperative Planning for Lymphovenous Anastomosis in Breast Cancer-Related Lymphedema."
Introduction: Lymphovenous anastomosis (LVA) is an advanced supermicrosurgical technique that offers a minimally invasive approach to treating breast cancer-related lymphedema (BCRL) (1). The procedure relies on the precise identification of lymphatic vessels and venules for successful anastomosis. Failure to locate suitable structures can compromise patency and reduce surgical success. While indocyanine green lymphography (ICG-L) has been widely used for lymphatic vessel visualization, it does not provide details on recipient vessels. Ultra-high frequency ultrasound (UHFUS) with a 70 MHz probe and color Doppler presents a potential advancement in preoperative mapping by offering highresolution imaging of small anatomical structures, including subdermal venules. This enhanced visualization may improve surgical precision and overall outcomes (2).
Aim of the study: The aim of this study was to assess the feasibility and efficacy of targeted preoperative planning using ICG-L and UHFUS for identifying lymphatic vessels and venules for LVA surgery. Additionally, surgical success was evaluated by comparing the number of planned and performed anastomoses. Secondary outcomes included arm volume, L-Dex score, LVA patency, and health-related quality of life.
Methods: This is a prospective pilot study including ten patients undergoing LVA at the Department of Plastic Surgery at Odense University Hospital. Preoperative planning was conducted using ICG-L and UHFUS to identify lymphatic vessels and venules. Patient assessments were conducted at baseline, three-, six-, nine- and twelve months.
Results: All ten patients underwent preoperative planning and LVA surgery successfully. On average, 2.2 (±1.03) lymphatic vessels were identified preoperatively, with a 94.2% rediscovery rate during surgery. Similarly, 2.1 (±0.99) venules were planned, and 82.5% were identified intraoperatively. A mean of 2.0 (±0.82) anastomoses were planned, with 81.7% successfully performed. Secondary outcomes are being collected and will be available by April 2025.
Conclusion: Optimized preoperative planning using ICG-L and UHFUS has proven to be a feasible and efficient approach, offering high precision with minimal risk or discomfort for patients. This method has also facilitated the transition from general to local anesthesia in our department. By allowing for a precise and targeted approach, this advancement not only improves the safety of the patient but also contributes to a successful and efficient surgical procedure.

Congratutations to Caroline on this recognition!