Kristiansen M, et al. - In view of the recent popularity of lymphaticovenular anastomosis (LVA) with supramicrosurgical technique as a treatment modality for cases with lymphedema, researchers here prospectively ascertained objective changes in leg volume in cases operated with LVA for lymphedema in the lower extremity. In addition, they sought positive predictors for the treatment method to facilitate the location of the venules and lymphatic vessels. Using lymphoscintigraphy and indocyanine green lymphography, examination of 31 consecutive patients with lymphedema in the lower extremity and positive pitting test was done. For the lymphedema, the causes were either cancer or unknown cause/primary lymphedema. Surgery was undertaken in 14 of the patients with pathological lymphangiographic patterns; of these, 12 were operated with one to four LVAs each. Five of 12 patients showed between 1–8% edema reductions in the lower extremity after 12 months. Outcomes suggest edema volumes, where the most distinctive positive predictor for edema reduction with LVAs was previous lymph node dissection, may reduce with supramicrosurgery with LVA.