Thoracic Duct Embolization via Retrograde Cannulation of a Leaking Stump through the Thoracic Cavity

Thoracic duct embolization has emerged as an alternative treatment for refractory chylothorax, in addition to thoracic duct ligation. Thoracic duct embolization is typically performed via direct puncture of the cisterna chyli and cannulation of the thoracic duct, or via a retrograde approach to the thoracic duct through the venous angle. The former requires a long puncture through abdominal organs; the latter has anatomical limitations depending on the case. The reported success rates of both approaches are insufficient to provide a complete solution. We report a case of refractory chylothorax successfully treated with thoracic duct embolization using a catheter inserted through a chest tube to cannulate the leaking stump of the thoracic duct. This technique offers a less invasive treatment option that avoids additional punctures or surgical intervention.