Related Experiment Video

Updated: Aug 30, 2025

Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
05:31

Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients

Published on: September 20, 2020

5.7K

Thoracic Duct Embolization Using Transabdominal Antegrade and Transcervical Retrograde Accesses

Daniel Crawford1, Carlos J Guevara1, Seung Kwon Kim1

  • 1Division of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University St. Louis School of Medicine, St. Louis, Missouri.

Journal of Vascular and Interventional Radiology : JVIR
|August 26, 2022
PubMed

Insights

Thoracic duct embolization (TDE) for chyle leaks shows good clinical success. Transabdominal antegrade access is more technically successful than transcervical retrograde access, but retrograde TDE aids complex cases.

Area of Science:

  • Interventional Radiology
  • Vascular Surgery
  • Gastroenterology

Background:

  • Chyle leaks, often resulting from iatrogenic causes or spontaneous events, pose significant clinical challenges.
  • Thoracic duct embolization (TDE) is an interventional technique used to manage chyle leaks.

Purpose of the Study:

  • To evaluate the technical success and clinical outcomes of TDE.
  • To compare transabdominal antegrade and transcervical retrograde access methods for TDE.

Main Methods:

  • Retrospective chart review of 99 patients undergoing 113 TDE procedures over 6 years.
  • Analysis of technical success rates for transabdominal antegrade and transcervical retrograde TDE.
  • Assessment of overall clinical success and adverse events.

Main Results:

  • Overall technical success rate for TDE was 77%.
  • Transabdominal antegrade access had a 68% technical success rate; transcervical retrograde access had a 44% success rate.
  • Clinical success (chyle leak resolution) was achieved in 83% of patients, with 8 SIR-classified adverse events.

Conclusions:

  • Transabdominal antegrade access offers higher technical success for TDE.
  • Transcervical retrograde access, though challenging, improves outcomes in cases of thoracic duct occlusion or small anatomy.
  • TDE is an effective treatment for chyle leaks, with combined approaches enhancing success rates.
Abstract

More Related Videos

Dual-phase Cone-beam Computed Tomography to See, Reach, and Treat Hepatocellular Carcinoma during Drug-eluting Beads Transarterial Chemo-embolization09:49

Dual-phase Cone-beam Computed Tomography to See, Reach, and Treat Hepatocellular Carcinoma during Drug-eluting Beads Transarterial Chemo-embolization

Published on: December 2, 2013

10.4K
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm04:56

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm

Published on: August 1, 2025

87

Related Concept Videos

Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
461
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
37
Veins of Thorax01:19

Veins of Thorax

The azygos system is a crucial part of the body's circulatory system and drains most of the thorax. It comprises the azygos, hemiazygos, and accessory hemiazygos veins.
The azygos vein, positioned just right of the midline and anterior to the vertebral column, begins at the junction of the right ascending lumbar and subcostal veins, terminating in the superior vena cava. This vein drains blood from the right side of the thoracic wall, thoracic viscera, and posterior abdominal wall.
The...
1.1K
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
18
Lymphatic Vessels and Lymph Transport01:16

Lymphatic Vessels and Lymph Transport

Lymphatic vessels, known as lymphatics, are crucial in transporting lymph from peripheral tissues to our venous system. This process begins with lymph entering through tiny capillaries that branch through tissues. These capillaries have unique features such as larger diameters, thinner walls, and a distinctive one-way valve system formed by overlapping endothelial cells.
This one-way system allows fluids, solutes, and even pathogens to enter but prevents their return to the intercellular...
8.5K