"Die-back" in primary lymphedema -- lymphographic and clinical correlations.

Both obliteration and dilatation of distal lymphatics are seen in primary lymphedema but it is only in secondary lymphedema that the lymphographic progression of the disease has been documented. In this retrospective study the same progression was found in 13 out of 20 patients had initial evidence of proximal lymphatic obstruction. In ten patients the lymphangiographic changes were associated with a clinical deterioration of the leg. These findings suggest some urgency in diagnosing those patients that may benefit from a lymph bypass procedure.