Background Several surgeons have described studies of free-tissue transfers using veins instead of arteries. These innovative microsurgical techniques can offer several advantages, such as an easier dissection during flap harvesting, and represent an alternative during an accidental surgical mistake or development of new surgical procedures. The purpose of this study was to describe and explore different constructs of vascularized lymph node transfer (VLNT) only based on venous blood flow in a mouse model, evaluate their blood flow microcirculation through indocyanine green (ICG) angiography and investigate the lymphatic drainage function and the lymph nodes’ structures. Methods Five types of venous lymph node flaps (LNF) were created and investigated: Types IA, IB, IC, IIA and IIB were developed by ICG intraoperatively (with videos in the article). Seven weeks later, by applying methylene blue, the recanalization of the lymphatic vessels between the LNF and the recipient site was detected. Lymph nodes were collected at the same time and their structures were analyzed by hematoxylin and eosin staining analysis. Results All of the venous LNFs developed except Type IC. Seven weeks later, methylene blue flowed into Types IA, IB, IIA and IIB from recipient sites. When comparing with arteriovenous lymph node, the medullary sinus was diffusely distributed in venous lymph nodes. The proportion of cells was significantly reduced (p < 0.05). The artery diameters were significantly smaller (p < 0.05). The veins diameters and lymphatic vessels output in Types IA, IB, IIA and IIB were more dilated (p < 0.05). Conclusions This research demonstrated that Type IA, IB, IIA and IIB venous LNFs can retrogradely receive venous blood supply; they can survive, produce a lymphatic recanalization and integrate with the surrounding tissue, despite lymph node structural changes. Our results will improve the understanding of the survival mechanism of venous LNFs and will help researchers to design new studies or lymphatic models and eventually find an alternative procedure for the surgical treatment of lymphedema.

中文翻译：

---

血管化的淋巴结皮瓣可以在没有动脉流入的情况下依靠静脉血存活：使用吲哚菁绿血管造影描述静脉血流动力学的实验模型（附图）

背景 几位外科医生描述了使用静脉而不是动脉进行自由组织移植的研究。这些创新的显微外科技术可以提供多种优势，例如在皮瓣采集过程中更容易解剖，并且代表了意外手术错误或新外科手术开发过程中的替代方案。本研究的目的是描述和探索仅基于小鼠模型静脉血流的血管化淋巴结转移（VLNT）的不同结构，通过吲哚青绿（ICG）血管造影评估其血流微循环，并研究淋巴引流功能和淋巴结的结构。方法 创建并研究五种类型的静脉淋巴结皮瓣（LNF）：IA、IB、IC、IIA 和 IIB 型是术中通过 ICG 开发的（文章中有视频）。七周后，通过应用亚甲蓝，检测到 LNF 和受体部位之间的淋巴管再通。同时收集淋巴结并通过苏木精和伊红染色分析其结构。结果 除IC型外，所有静脉LNF均发育。七周后，亚甲蓝从受体部位流入 IA、IB、IIA 和 IIB 型。与动静脉淋巴结相比，髓窦广泛分布于静脉淋巴结中。细胞比例显着减少(p＜0.05)。动脉直径明显更小(p＜0.05)。IA、IB、IIA 和 IIB 型的静脉直径和淋巴管输出量更大（p < 0.05）。结论本研究证明IA、IB、IIA、IIB型静脉LNF可逆行接受静脉血供；尽管淋巴结结构发生变化，它们仍能存活、产生淋巴管再通并与周围组织融合。我们的研究结果将增进对静脉LNF生存机制的理解，并将帮助研究人员设计新的研究或淋巴模型，并最终找到手术治疗淋巴水肿的替代方法。