In this review, I explained the reason why the mesenteric lymph was named “white blood” by Hippocrates in ancient Greece, as opposed to the lymph originating from other organs. Next, the relationship between Japanese Society of Angiology and Lymphology was clarified. One of topics in current lymphatic research, Glymphatic pathway demonstrated by Drs. Iliff and Nedergaard was introduced. Finally, as the impressive studies of our current lymphatic research, I addressed the findings that water intake increases mesenteric lymph flow and the total flux of albumin, long-chain fatty acids, and IL-22 in rats. The traditional Japanese health care system, known recommends that a suitable volume of water be consumed every day, e.g., by drinking green tea. However, the physiological and immunological mechanisms in support of this traditional practice are still unknown. We demonstrated as one of the mechanisms that IL-22 released from ILC-3 is transported through mesenteric lymph in collaboration with the albumin-mediated movement of consumed water. In addition, I demonstrated the study that the lymph flow rate through thoracic duct in human subjects can evaluate using changes in urine osmolarity with water intake and abdominal respiration, which are applicable for evaluating the skill of lymph edema therapists.

A woman in her 60s presented with varicose veins. Ultrasonography showed great saphenous vein (GSV) reflux and incompetent perforating veins (IPVs) in the lower medial thigh. At the 3-month follow-up after endovenous thermal ablation for GSV and pulse mode percutaneous ablation of perforators (PAPS) using a 1470-nm Radial 2ring slim fiber (output=6.5 W, duration:pause 1:1s) for IPVs, the patient showed no symptoms or complications. Ultrasonography showed no GSV reflux or IPV. This method can be used to treat IPVs. PAPS, which produces sufficient heat for IPV occlusion and less heat diffusion to surrounding tissue, is another treatment option.

We report a case of a 78-year-old female with an infected abdominal aortic aneurysm which dilated by 30 mm over 3 days and ruptured. She presented to a hospital with diarrhea and was diagnosed with an infected abdominal aortic aneurysm following a CT scan. She was subsequently transferred to our facility and commenced on antibiotics. On the third day of admission, a physiotherapist noticed rapid growth of her abdomen. An emergency CT scan demonstrated rapid dilatation and sings of aortic rupture, for which non-anatomical surgical repair was performed. Salmonella was isolated from cultures.

A 65-year-old man was admitted to our hospital complaining of back pain. A contrast-enhanced computed tomography scan detected Stanford type B acute aortic dissection. Although the celiac artery was occluded, the distal hepatic artery was enhanced. We performed an emergent thoracic endovascular aortic repair. Levels of liver enzymes were elevated after we commenced enteral feeding. Liver ischemia was suspected due to a decrease in collateral flow. Thus, we performed hepatic artery bypass by the great saphenous vein. The finding of liver ischemia was disappeared after the surgery.

We experienced a case of a rare dorsalis pedis artery aneurysm. The patient was a 55-year-old man who had been experiencing pain and swelling in the dorsum of his right foot for six months and was referred to our clinic. An aneurysm of 23 mm in diameter was found by CT. The aneurysm was resected and revascularization using the great saphenous vein was performed. Pathological findings showed dissection in the tunica media of the arterial wall and plaque in the intima, and the patient was diagnosed as a true atherosclerotic dorsalis pedis artery aneurysm.

We present a case of an iliac artery aneurysm repair in a 51-year-old man, who underwent renal transplantation at the age of 25 years. Abdominal ultrasonography and computed tomography demonstrated a saccular aneurysm at the right common and internal iliac artery. During aortic clamping, the transplanted kidney was preserved through an axillo-femoral artery bypass and cold renal perfusion. Revascularization was accomplished with a bifurcated graft. No significant postoperative complications were observed. The patient’s recovery was uneventful, and his renal function returned to preoperative values.

Arch replacement was performed to treat type A acute aortic dissection in two patients with abdominal aortic aneurysm in the acute stage. In the second stage of treatment, we performed abdominal aortic replacement and thoracic endovascular aortic repair, expecting to achieve residual entry closure and aortic remodeling. No complications of postoperative paraplegia were observed in the two patients. Postoperative computed tomography showed good aortic remodeling was achieved. This procedure might be a safe and useful treatment option.