Lymphangiography and thoracic duct embolization following unsuccessful thoracic duct ligation: Imaging findings and outcomes

The Journal of Thoracic and Cardiovascular Surgery
Gregory J Nadolski, Maxim Itkin

Abstract

To summarize the imaging findings and outcomes of thoracic duct (TD) embolization (TDE) performed in patients with chylous leaks persisting after TD ligation (TDL). In this review of 50 patients (30 males and 20 females; median age, 54 years) referred for TDE following unsuccessful surgical TDL, records were reviewed for lymphangiographic findings, technical success of TDE, and outcome of TDE. Comparisons between groups were performed using the Fisher exact test. The causes of chylothorax were traumatic in 39 patients (78%) and nontraumatic in 11 (22%). Lymphangiography identified missed TDL in 30 patients (60%) and complete TDL in 15 patients (30%); however, in 12 of these 15 patients, collaterals around the ligation site supplying the leak could be identified. Incomplete ligation was observed in 4 patients (8%). In 1 patient (2%), a second TD was identified circumventing a complete ligation of the main TD. TDE was performed in 49 patients, and TD disruption was performed in 1 patient. Resolution of the chylous leak occurred in 45 patients (90%). There were 3 minor complications that resulted in no clinical sequela. TDE produced cessation of chylous leak in the majority of the patients with persistent chylothorax after surgica...Continue Reading

Citations

Dec 14, 2019·The Korean Journal of Thoracic and Cardiovascular Surgery·Hyuncheol JeongJungseop Eom
Feb 13, 2020·Journal of Magnetic Resonance Imaging : JMRI·Waleska M Pabon-RamosLynne M Koweek
Mar 28, 2020·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·Christof M SommerGoetz M Richter
Feb 8, 2021·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Laser Arif BazancirMichael Patrick Achiam
Mar 17, 2021·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Robert PowerJohn V Reynolds
Jul 1, 2020·Thoracic Surgery Clinics·Jonathan C Yeung
Apr 13, 2021·Langenbeck's Archives of Surgery·C M SommerS Hur
Apr 29, 2021·Yonsei Medical Journal·Yiyoung KwonMi Jin Kim
Aug 7, 2021·Journal of Chest Surgery·Hyo Yeong Ahn, Hoseok I
Aug 28, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Maricarmen RochéRodríguez, James A DiNardo

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