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Transvenous Retrograde Thoracic Ductography: Initial Experience with 13 Consecutive Cases.

Shuji Kariya1, Miyuki Nakatani2, Yutaka Ueno2

  • 1Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. kariyas@hirakata.kmu.ac.jp.

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PubMed
Summary

Transvenous retrograde thoracic ductography achieved a 61.5% success rate in 13 patients with chylous effusions. Success was higher (80%) when the thoracic duct

Keywords:
Chylous effusionLeakageLymphangiographyThoracic ductTransvenous thoracic ductography

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Area of Science:

  • Interventional Radiology
  • Thoracic Surgery
  • Vascular Medicine

Background:

  • Chylothorax, chylous ascites, and chylous pericardial effusion necessitate treatment.
  • Conservative management is often insufficient for these conditions.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of transvenous retrograde thoracic duct cannulation.
  • To assess the efficacy of this technique in patients with lymphatic fluid leakage.

Main Methods:

  • Retrospective analysis of 13 patients undergoing transvenous retrograde thoracic ductography.
  • Lymphangiography to identify the thoracic duct-vein junction.
  • Microcatheter insertion into the thoracic duct via the venous system.

Main Results:

  • Successful cannulation of the thoracic duct was achieved in 12 patients (92.3%).
  • Thoracic ductography was successful in 8 patients (61.5%), with higher success rates for simple cervical duct types (80%).
  • One patient with chylous pericardial effusion underwent successful thoracic duct embolization.

Conclusions:

  • Transvenous retrograde thoracic ductography is a feasible technique for managing lymphatic leakage.
  • The success of the procedure is influenced by the anatomical configuration of the thoracic duct.
  • This approach may offer an alternative for patients with refractory chylous effusions.