[Anasatomoses between the superficial and deep lymphatic systems in the lower limb]

Area of Science:

• Anatomy
• Lymphatic System
• Vascular Anatomy

Context:

• The lymphatic system's role in fluid balance and immunity is critical.
• Understanding lower limb lymphatic drainage is essential for surgical procedures and diagnosing lymphedema.
• Previous studies have provided foundational knowledge, but detailed anatomical variations require further investigation.

Purpose:

• To investigate and document the existence and variations of perforating and anastomosing lymphatic vessels in the human lower limb.
• To classify the different anatomical patterns of lymphatic communication between superficial and deep systems.
• To quantify the prevalence of identified lymphatic vessel variants in a cohort of 183 cases.

Summary:

• Analysis of 183 lower limb dissections identified perforating lymphatic vessels connecting superficial and deep systems.
• Six distinct variants of perforating lymphatic systems were described, with four originating superficially and two deeply.
• The most frequent variant (9.3% of cases) involved superficial lymphatics from the internal saphenous system connecting to the deep posterior tibial system.
• Three systems of communicating lymphatic vessels (two superficial, one deep) were also identified.
• Perforating systems were present in 12% of cases, and communicating systems in 2%.

Impact:

• Provides detailed anatomical insights into lower limb lymphatic pathways.
• Contributes to a better understanding of lymphatic collateral circulation.
• Offers valuable data for surgeons, radiologists, and anatomists involved in lower limb vascular and lymphatic procedures.
• Enhances diagnostic accuracy for conditions affecting lymphatic drainage in the lower extremities.