As a result of the observation of oedemas of the lower extremities and lymphorrhoea in the immediate postoperative course of surgical reconstruction of the aorto-iliaco-femoro-popliteal arterial axis (and on the basis of similar cases in the literature), the participation of the lower extremity return circulation in this facet of vascular surgery has been documented. The venous system was never impaired whereas the local lymphatic system was always damaged by surgical aggression on the arterial vessels. However, the extensive anatomical lesions shown up by lymphography are not reflected in evident clinical signs; whenever oedema or lymphorrhoea of the surgical wounds are observed, these symptoms are always of slight importance and easily and quickly resolved. At long-term follow-up, no clinical evidence of impairment ot the venous and lymphatic venous return circulation was ever encountered. For prophylactic purposes the lymphatic structure encountered during the operation should be carefully ligated to counteract another dangerous complication: infection.
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