Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2012; 22(02): 89-92
DOI: 10.4103/0971-3026.101077
Interventional Radiology

Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy

Alampath Praveen
Department of Radiology, Amrita Institute of Medical Sciences, Kochi-682041, India
,
Karumathil Pullara Sreekumar
Department of Radiology, Amrita Institute of Medical Sciences, Kochi-682041, India
,
Puthukudiyil Kader Nazar
Department of Radiology, Amrita Institute of Medical Sciences, Kochi-682041, India
,
Srikanth Moorthy
Department of Radiology, Amrita Institute of Medical Sciences, Kochi-682041, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct.

Keywords

Chylothorax - thoracic duct embolization - MRCP - direct glue injection without cannulation


Publication History

Article published online:
30 July 2021

© 2012. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Erden A, Fitoz S, Yagmurlu B, Erden I. Abdominal confluence of lymph trunks : D0 etectability and morphology on heavily T2-weighted images. AJR Am J Roentgenol 2005;184:35-40.
  • 2 Paul Buttler. Applied Radiological anatomy . In: 0 Mitchell AM, Ellis H, editors. Limb vasculature and lymphatic system. 2 nd ed. R0 aven Press: New York; 1995. P. 381-97.
  • 3 Itkin M, Kucharczuk JC, Kwak A, Trerotola SO, Kaiser LR. Nonoperative thoracic duct embolization for traumatic thoracic duct leak : E0 xperience in 109 patients. J Thorac Cardiovasc Surg 2010;139:584-89.
  • 4 Dugue L, Sauvanet A, Farges O, Goharin A, Le Mee J, Belghiti J. Outputof chyle as an indicator of treatment for chylothorax complicating oesophagectomy. Br J Surg 1998;85:1147-9.
  • 5 Alexiou C, Watson M, Beggs D, Salama FD, Morgan WE. Chylothorax following oesophagogastrectomy for malignant disease. Eur J Cardiothorac Surg 1998;14:460-6.
  • 6 Merigliano S, Molena D, Ruol A, Zaninotto G, Cagol M, Scappin S, et al. Chylothorax complicating esophagectomy for cancer : a0 plea for early thoracic duct ligation. J Thorac Cardiovasc Surg 2000;119:453-7.
  • 7 Valentine VG, Raffin TA. The management of chylothorax. Chest 1992;102:586-91.
  • 8 Marts BC, Naunheim KS, Fiore AC, Pennington DG. Conservative versus surgical management of chylothorax. Am J Surg 1992;164:532-5.
  • 9 Christodoulou M, Ris HB, Pezzetta E. Video-assisted right supradiaphragmatic thoracic duct ligation for non-traumatic recurrent chylothorax. Eur J Cardiothorac Surg 2006;29:810-4.
  • 10 Merigliano S, Molena D, Ruol A, Zaninotto G, Cagol M, Scappin S, et al. Chylothorax complicating esophagectomy for cancer : a0 plea for early thoracic duct ligation. J Thorac Cardiovasc Surg 2000;119:453-7.
  • 11 Cope C, Salem R, Kaiser LR. Management of chylothorax by percutaneous catheterization and embolization of the thoracic duct : p0 rospective trial. J Vasc Interv Radiol 1999;10:1248-54.
  • 12 Bonn J, Sperling D, Walinsky P, Mannion J. Percutaneous embolization of thoracic duct injury. Circulation. 2000;102:268-9.
  • 13 van Goor AT, Kröger R, Klomp HM, de Jong MA, van den Brekel MW, Balm AJ. Introduction of lymphangiography and percutaneous embolization of the thoracic duct in a stepwise approach to the management of chylous fistulas. Head Neck 2007;29:1017-23.
  • 14 Schild H, Hirner A. Percutaneous translymphatic thoracic duct embolization for treatment of chylothorax. Rofo 2001;173:580-2.
  • 15 Patel N, Lewandowski RJ, Bove M, Nemcek AA Jr, Salem R. Thoracic duct embolization : a0 new treatment for massive leak after neck dissection. Laryngoscope 2008;118:680-3.
  • 16 Litherland B, Given M, Lyon S. Percutaneous radiological management of high-output chylothorax with CT-guided needle disruption. J Med Imaging Radiat Oncol 2008;52:164-7.
  • 17 Boffa DJ, Sands MJ, Rice TW, Murthy SC, Mason DP, Geisinger MA, et al. A critical evaluation of a percutaneous diagnostic and treatment strategy for chylothorax after thoracic surgery. Eur J Cardiothorac Surg 2008;33:435-9.
  • 18 Erden A, Fitoz S, Yagmurlu B, Erden I. Abdominal confluence of lymph trunks : D0 etectability and morphology on heavilyT2-weighted images. AJR Am J Roentgenol 2005;184:35-40.
  • 19 Rosenberger A, Abrams HL . R0 adiology of the thoracic duct . A0 m J Roentgenol Radium Ther Nucl Med 1971;111:807-20.
  • 20 Smith TR, Grigoropoulos J . T0 he cisterna chili: Incidence and characteristics on CT. Clin Imaging 2000;26:18-22.
  • 21 Boffaa DJ, Sandsb MJ, Ricea TW, Murthya SC, Masona DP, etal . A0 critical evaluation of a percutaneous diagnostic and treatment strategy for chylothorax after thoracic surgery. Eur J Cardiothorac Surg 2008;33:435-9.