A protocolized approach to chyle leaks to mitigate prosthetic graft infection

A 63-year-old man presented to the vascular surgery clinic with an enlarging left subclavian artery aneurysm owing to proximal compression by the anterior scalene muscle. He underwent open repair with a rifampin-soaked Dacron graft and developed a postoperative chyle leak. We describe our management and propose a protocolized deployment of surgical, dietary, pharmacological, and interventional techniques to resolve chyle leaks rapidly and prevent infections in the presence of a prosthetic vascular graft.