Arteriovenous shunts in peripheral lymphedema: hemodynamic features and isotopic visualization

The hemodynamic characteristics of peripheral lymphedema were studied in 28 patients with uni- or bilateral leg swelling. Leg blood flow was measured by venous isotope dilution (a technique for nutritive--capillary blood flow) and arteriovenous shunts were visualized by perfusion scintigraphy using radiolabelled macroaggregated albumin. Arteriovenous communications were uniformly detected in lymphedema, with a calculated "shunt flow" of 200 to 600 ml/min. Other features in the lymphedematous leg included an elevated limb blood flow rate and narrowed arteriovenous oxygen difference.