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Lymphatic imaging and intervention for chylothorax following thoracic aortic surgery
Cheng Shi Chen1, Jong Woo Kim2, Ji Hoon Shin1,2
1Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou.
Medicine
|August 28, 2020
Summary
Lymphatic intervention using lymphangiography and thoracic duct embolization (TDE) is effective for managing chylothorax after thoracic aortic surgery. This minimally invasive approach shows high success rates in resolving lymphatic leakage and improving patient outcomes.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Thoracic Surgery
Background:
- Chylothorax is a rare but serious complication following thoracic aortic surgery.
- Limited data exists on the efficacy of lymphatic interventions for this specific patient population.
Purpose of the Study:
- To evaluate the technical and clinical outcomes of lymphangiography and thoracic duct embolization (TDE) in patients experiencing chylothorax post-thoracic aortic surgery.
Main Methods:
- Retrospective review of nine patients who underwent lymphatic interventions for chylothorax after thoracic aortic surgery.
- Utilized conventional lymphangiography and thoracic duct embolization (TDE).
- Magnetic resonance (MR) lymphangiograms were used in five patients for initial assessment.
Main Results:
- Conventional lymphangiography demonstrated a technical success rate of 88.9%.
- Thoracic duct embolization (TDE) achieved a clinical success rate of 87.8%, with a significant reduction in daily drainage (710.0 mL/day to 109.7 mL/day).
- Both antegrade (75%) and retrograde (100%) TDE approaches via pleural access showed high technical success.
Conclusions:
- Conventional lymphangiography and TDE are safe and effective minimally invasive techniques for managing chylothorax after thoracic aortic surgery.
- These interventions yield high technical success rates and favorable clinical outcomes, including reduced lymphatic leakage.
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