Add like
Add dislike
Add to saved papers

[Transnodal ultrasound-guided lymphangiography for thoracic duct embolization in chylothorax].

INTRODUCTION: To evaluate the feasibility of ultrasound-guided transnodal lymphangiography as an modified technique for visualization of the abdomino-thoracic lymphatic system for thoracic duct embolization in patients with chylothorax after thoracic surgery.

METHODS: 10 patients (six men and four women, mean age 53 y [range, 22-72 y]) with chylothorax after thoracic surgery underwent ultrasound-guided transnodal lymphangiography. An inguinal lymph node was accessed under ultrasound guidance with a 25-gauge spinal needle and lipiodol was injected. Opacification of the lymphatic system was intermittently controlled by fluoroscopy. The thoracic duct was percutaneously accessed and embolization was performed. Following mean times were assessed: for the procedure of inguinal puncture, number of inguinal punctures, time from start of lipiodol injection until inguinal lymphangiogram, volume of injected contrast media, duration of opacification of target lymphatics, number of percutaneous punctions and time for thoracic duct access, time for thoracic duct embolization and complications. Procedure times until initial lymphangiogram were compared with times of a control group (n=10) in patients who had undergone pedal lymphangiography.

RESULTS: The procedure of ultrasound guided lymph node puncture was successful in all cases (10 /10). Mean procedure times from inguinal access to initial lymphangiogram were 12.3 ± 2 minutes (pedal lymphangiography : 30.4 ± 5 minutes). Average of inguinal punctions was 1.3 (1-3). Small extravasation occurred in 4 of 10 patients. In 2 patients a contralateral inguinal punction was necessary because of lymphovenous shunts. In 10 /10 patients the lymphatic systems was opacified about 24.5 ± 9 minutes for thoracic duct embolization without required additional injection. Average of thoracic duct punctions were 1.5 (1-3). Procedure times until catheterization of the target lymphatics and until embolization of the thoracic duct were 19.3 ± 9 minutes and 14.5 ± 2 minutes respectively.

CONCLUSION: Ultrasound-guided transnodal lymphangiography is a less technically challenging technique for opacification of the abdomino-thoracal lymphatic system for subsequent thoracic duct embolization.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app