We were able to observe several IF images in which the ICG solution ran from the forearm to the upper arm immediately after the injection of the solution in all five healthy volunteers. We also observed that the IF images reached the axilla area within 4–5 min after the injection of ICG in the normal arms. When the ICG solution was injected at the base of the thumb and forefinger, the lymph vessels were observed to run nearly straight to the deltoid muscle area. When the ICG solution was injected at the root of the third finger, the lymph vessel’s lines ran toward the axilla region after surrounding the elbow. The networks are demonstrated in an upper arm and forearm in Fig. 39.5.

The speed of the IFG lymphatic flow became extremely slow compared to the normal arms. The normal IFG lymph flows were observed as a linear pattern (Fig. 39.6a). Abnormal IF images of lymphedema were classified into three characteristic patterns called “dermal backflow (DB)”: the splash (Fig. 39.6b), stardust (Fig. 39.6c), and diffuse (Fig. 39.6d) patterns. In the present study, these patterns were confirmed in the BCRL patients with lymphedema of the limbs.

A case was reported in which the lymphedema of the upper limb was dramatically improved by CDP (Figs. 39.7 and 39.8). We observed many instances of DB (the splash pattern) in the IF images of the superficial lymph flow in the BCRL patients’ forearms before CDP (Fig. 39.7a). We marked the lymphedema points for the IF imaging (Fig. 39.7b). The splash pattern decreased and the linear pattern appeared on the forearm in one patient after 1 year of CDP treatment (Fig. 39.8a, b).