Combination of Lymph Node Embolization and Musculocutaneous Flap Operation for Managing Groin Lymphorrhea

Lymphorrhea complications are common following femoral exposure for endovascular procedures. In patients unresponsive to either non-operative or operative therapy, treatment can be complicated. A 86-year-old male patient experienced lymphorrhea after stent graft to treat an abdominal aortic aneurysm, and five operative debridement attempts failed. Intranodal lymphangiography revealed leakage points from two lymph nodes directly into the wound, which were resolved by lymph node embolization using glue. Because the wound was large, a pedicled anterolateral thigh flap (ALT) operation was indicated. Percutaneous lymph node embolization combined with ALT operation may be effective for patients with large wounds and high-flow lymphatic leaks.