CLT Lymphatic Imaging & Surgical Interventions for Lymphedema

Question 1

Which imaging study is widely considered the standard for confirming a lymphedema diagnosis and assessing lymphatic function?

Accepted Answer

Lymphoscintigraphy

Answer

In lymphoscintigraphy, a radiotracer such as technetium-99m-labeled colloid is injected and its uptake and transport through the lymphatics are imaged. It shows delayed transport, dermal backflow, and missing or reduced lymph nodes.

Question 2

What does indocyanine green (ICG) lymphography show that makes it useful for planning lymphedema surgery?

Accepted Answer

Superficial lymphatic vessels and dermal backflow patterns, seen in real time under near-infrared light

Answer

ICG is a fluorescent dye that shows up under near-infrared imaging. It maps functioning superficial lymphatic vessels and dermal backflow patterns (linear, splash, stardust, diffuse), which are used for staging and for finding vessels suitable for bypass.

Question 3

Lymphaticovenous anastomosis (LVA) is generally most effective in which patients?

Accepted Answer

Patients with early-stage lymphedema who still have functioning lymphatic vessels

Answer

LVA microsurgically connects functioning lymphatic vessels to nearby venules so that lymph bypasses the obstruction. It needs lymphatics that still contract and carry fluid, so results are best in earlier, fluid-dominant stages.

Question 4

What is a key risk at the donor site in vascularized lymph node transfer (VLNT)?

Accepted Answer

Iatrogenic (surgically caused) lymphedema in the limb or region the nodes were taken from

Answer

Taking lymph nodes from a donor site such as the groin can disrupt drainage there and cause new lymphedema. Surgeons reduce this risk with techniques like reverse lymphatic mapping to protect the nodes that drain the nearby limb.

Question 5

After suction-assisted lipectomy (liposuction) for late-stage, fat-dominant lymphedema, what is essential to keep the result?

Accepted Answer

Wearing compression garments around the clock for life

Answer

Liposuction removes the excess fatty tissue that builds up in chronic lymphedema but does not repair lymphatic transport. Without lifelong 24/7 compression, the limb volume comes back, so continued compression is a condition of the procedure.

CLT - Certified Lymphatic Therapist Practice Test

CLT - Certified Lymphatic Therapist Practice Test

CLT Lymphatic Imaging & Surgical Interventions for Lymphedema