Phlebolymphemeda: Usually Unrecognized,Often Poorly Treated

Abstract

Phlebolymphedema is a condition of mixed venous and lymphatic insufficiency. It is usually not recognized and it is usually not treated. The lymphatic and venous systems are intimately interrelated. In the presence of venous hypertension, which is characteristic of most venous disorders, the increase in lymphatic flow becomes much greater than the lymph transport capacity. The diagnosis of phlebolymphedema is based on a detailed history and physical examination. Patients with phlebolymphedema have skin changes of venous insufficiency, which are easy to recognize. Treatment for chronic phlebolymphedema consists of treating the venous abnormality and watching regression of the lymphatic problem.

Keywords

lymphedema phlebolymphedema venous disorders varicose veins chronic venous insufficiency

Get full access to this article

View all access options for this article.

References

Szuba A. , Rockson SG Lymphedema: anatomy, physiology and pathogenesis. Vasc Med . 1997;2:321-326.

Franzeck UK , Haselbach P. , Speiser D. , Bollinger A. Microangiopathy of cutaneous blood and lymphatic capillaries in chronic venous insufficiency (CVI). Yale J Biol Med. 1993 ;66:37-46.

Mortimer PS Evaluation of lymphatic function: abnormal lymph drainage in venous disease . Int Angiol. 1995; 14(3 suppl 1):32-35.

Partsch H. Investigations on the pathogenesis of venous leg ulcers. Acta Chir Scand Suppl. 1988;544:25-29.

Collins PS , Villavicencio JL , Abreu SH , et al.. Abnormalities of lymphatic drainage in lower extremities: a lymphoscintigraphic study. J Vasc Surg. 1989 ;9:145-152.

Rockson SG Diagnosis and management of lymphatic vascular disease. J Am Coll Cardiol. 2008;52:799-806.

Aström KG , Abdsaleh S. , Brenning GC , Ahlström KH MR imaging of primary, secondary, and mixed forms of lymphedema. Acta Radiol. 2001;42:409-416.

Weissleder H. Diagnosis of lymphostatic edema of the extremities . Fortschr Med. 1997;115:32-36.

Szuba A. , Razavi M. , Rockson SG Diagnosis and treatment of concomitant venous obstruction in patients with secondary lymphedema. J Vasc Interv Radiol. 2002; 13:799-803.

10.

Raju S. , Owen S. Jr , Neglen P. Reversal of abnormal lymphoscintigraphy after placement of venous stents for correction of associated venous obstruction. J Vasc Surg. 2001;34:779-784.