b'Standardized Definitions of Disease: 4. Therapeutic Devices, Surgical or Need objective documentation of appropriate Interventional Radiology Treatments of standards for the diagnosis of lymphedema,Lymphedema or other Lymphatic Diseaseslipedema, and other chronic edematous conditions.Need the study of lymphatic medicine included as Improve lymphatic microsurgery by using robotics,a discipline taught in medical school and included virtual reality, augmented reality, and/or artificial as an integral part of the cardiovascular system.intelligence to enhance training and increase the Need to better characterize the sex-specific number of lymphatic micro-surgeons. How can the strategy of surgical prevention of patterns of obesity and regional adipose definitionin order to understand when the pathology oflymphedema in cancer operations or treatment oflipedema is present. other lymphatic diseases be further refined withDevelop and measure core outcome measures regard to technique? Longer-term outcomes need to be evaluatedfor lymphedema/lymphatic disease therapiststo optimize clinical care and bring consistency for lymph node transfer and lymphaticovenous to lymphedema/lymphatic disease research anastomosis for lymphedema. outcome goals. Further research to determine which patientsvascularized lymph node transfer and/or Awareness campaign to help providers better understand their patients with lymphatic disease. lymphaticovenous anastomosis is effective toaid in patient selection.2. Lymph Collection and Analysis Large-scale prospective clinical trials are needed toDevelopment of clinically relevant approaches/ determine optimal treatment algorithms. (Some do well, but those with an inflammatory component to methods/technologies for lymph sampling andlymphedema do not do as well.)comprehensive multi-omics analysis of lymphMechanisms of immunomodulation following fluid in vitro.Integrate diagnosis and targeting of lymphatic vascularized lymph node transplant need to be elucidated to aid development of pharmacological cell populations. therapies.Surveillance of cancer cells in lymph flow toNeed for large scale prospective trials analyzing provide earlier insights into metastases andimprove cancer. outcomes of lymphedema surgery with a goal of defining optimal surgical algorithms and analyzing3. Lymphatic Specific Pharmacotherapies these outcomes long-term. Studies like this are and Targeted Therapies needed for insurance coverage.Understanding post-surgical lymphedema preventionand long-term surveillance for current breast cancer We lack medications that improve lymphatic function without causing significant off-target toxic effects.surgical reconstruction procedures.We lack drug mechanism studies. How to improve and tailor Phase 2 CompleteHow do we evaluate drug resistance (pathwayDecongestive Therapy self-management activities investigation)? for the person living with lymphedema.Inhibition of lymphatic signaling in tumor metastasis. Examine the role of complete decongestive therapyNovel methods of drug delivery (viral vectors, in rehabilitation pre- and post-surgical treatment.CAR T-cell therapy).Examine the adherence and outcomes of peopleIs there a role for pharmacology in lymphedemaliving with lymphedema to use of pneumaticprevention? compression devices across the lifespan.Novel compression device development andIs there a role for pharmacology in lipedema prevention or treatment? comparison studies with current approved devices.Does leukotriene biology offer opportunities forInterventions to manage lymphedema in advancedrelated lymphatic diseases like vascular malformation,cancer and innovation in palliative care. lymphagiectasia, lipedema, and others? Need for further development of novel techniques in Causes and interventions for complications ofmagnetic resonance lymphangiography.lymphatic disease and lymphedema (e.g., lymphaticNeed for novel interventional radiology preventativepain, disfiguration, fibrosis, and coagulopathy). and therapeutic approaches to lymphatic disease. Need for interventional radiology drug deliveryoptions. |Gaps in the Field of Lymphatic Research|2024 Update|3'