Rockson SG.
Curr Treat Options Cardiovasc Med 2000 Jun;2(3):237-242

Division of Cardiovascular Medicine, Stanford University School of Medicine,
Stanford, CA 94305, USA.

Aggressively applied decongestive measures (eg, manual lymphatic drainage,
low-stretch bandaging, exercise, skin care, application of compressive elastic
garments) are the mainstay of lymphatic therapy. Therapeutic regimens should
differentiate between the goals of acute volume reduction and the maintenance of
limb volume. Elastic garments should not be employed until maximal volume
reduction has been attained through decongestive lymphatic techniques. It is my
opinion that use of intermittent pneumatic compression devices can play an
important adjunctive role to decongestive lymphatic therapy but should not be
substituted for these techniques. At this time, I am not inclined to use
pharmacologic therapy in these patients but anxiously await the results of
studies that might demonstrate efficacy for molecular approaches. Surgical
intervention is reserved for a small number of well-selected patients.
Liposuction for volume reduction appears to be a very promising approach for
specific patients.