Preoperative and postoperative considerations of micro-arteriovenous fistulas in patients with lower limb lymphedema

Summary: Abstract Body: This study aims to explore preoperative and postoperative considerations for managing micro-arteriovenous fistulas (AVFs) in patients with lower limb lymphedema, focusing on optimizing surgical outcomes and long-term care strategies. A comprehensive review of the literature was conducted using PubMed to identify studies addressing the diagnosis, management, and outcomes of micro-AVFs in lower limb lymphedema. The analysis included studies on surgical techniques, perioperative care, imaging modalities, and long-term management. Preoperative considerations emphasize accurate diagnosis through imaging modalities such as Doppler ultrasound and CT angiography, patient risk stratification, and optimization of medical therapy, including compression therapy and infection control. Postoperative care involves rigorous wound care, pain management, and rehabilitation, including manual lymphatic drainage and compression therapy. Studies show that surgical interventions, including ligation of micro-AVFs, result in significant reductions in limb volume and improvements in quality of life. However, outcomes are influenced by patient adherence to postoperative protocols, the severity of preoperative conditions, and comorbidities. Recurrence and persistent edema remain challenges requiring multidisciplinary management. Micro-AVF interventions hold promise for improving outcomes in patients with refractory lower limb lymphedema. Optimizing perioperative care, standardizing protocols, and addressing long-term challenges such as recurrence and complications are critical for enhancing clinical outcomes. Future research should focus on large-scale, standardized trials and the integration of advanced imaging and hybrid techniques to refine patient selection and treatment strategies. Andre Aabedi¹, Vera Wang¹ 1. Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, CA, United States. Clinical Research: Epidemiology and Observational Research