Post-arterial reconstruction edema, are lymphatic channels to blame?

Edema which follows successful arterial reconstruction of a previously ischemic lower limb is a common observation. Most patients have no long term difficulty, but this side effect requires considerable attention to leg care and frequently delays resumption of normal activity. Earlier studies suggested various causes. This study looked into lymphatic causes. 125I RIHSA clearance was monitored in 4 patients who developed edema following femoropopliteal bypass, and 5 patients who did not develop edema following other vascular procedures. In the edematous limbs following successful femoropopliteal bypass grafting, the mean T 1/2 was 18.4 hours when compared to 52.7 hrs. in other procedures (p less than .025). This indicates increased lymphatic flow of the distal superficial lymphatics. It is concluded that post reconstruction edema is not due to lymphatic disruption but is instead of multifactorial origin.