Intranodal Lymphangiography with Thoracic Duct Embolization for Treatment of Chyle Leak after Thoracic Outlet Decompression Surgery

J Vasc Interv Radiol. 2020 May;31(5):795-800. doi: 10.1016/j.jvir.2020.02.006.

Abstract

From 2015 to 2019, 9 patients underwent ultrasound-guided intranodal lymphangiography for the treatment of a chyle leak following thoracic outlet decompression surgery. Chyle leaks were identified by Lipiodol (Guerbet, Roissy, France) extravasation near the left supraclavicular surgical bed in all patients. The technical success rate of thoracic duct embolization was 67% (6 of 9), including fluoroscopic transabdominal antegrade access (n = 4) and ultrasound-guided retrograde access in the left neck (n = 2). Clinical success was achieved in 89% of patients (8 of 9). The mean interval from lymphangiography to drain removal was 6.6 days (range, 4-18 d). No patients had a chyle leak recurrence during clinical follow-up (mean, 304 d).

MeSH terms

  • Adult
  • Chyle / diagnostic imaging*
  • Decompression, Surgical / adverse effects*
  • Embolization, Therapeutic* / adverse effects
  • Female
  • Humans
  • Lymphography*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Thoracic Duct / diagnostic imaging*
  • Thoracic Duct / injuries
  • Thoracic Outlet Syndrome / diagnostic imaging
  • Thoracic Outlet Syndrome / surgery*
  • Time Factors
  • Treatment Outcome
  • Young Adult