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淋巴泄漏 - - 淋巴管内淋巴管成像第一次战略的成功

Alan Campbell¹, Diana Velazquez-Pimentel², Matthew Seager³

¹University College London Hospital NHS Foundation Trust, London, UK.

CVIR endovascular

|January 9, 2025

概括

内节淋巴血管学 (ILAG) 为大量淋巴泄漏提供一线治疗. 结合对耐药病例的栓塞,它实现了69%的临床成功率,为那些对其他疗法没有反应的患者提供了希望.

科学领域:

干预性放射学干预性放射学
血管医学血管医学
淋巴系统研究淋巴系统研究

背景情况:

淋巴泄漏导致显著的死亡率和发病率.
内节淋巴血管学 (ILAG) 涉及向淋巴结注入以化脂质,用于诊断和潜在的治疗性硬化症.
这项研究评估了ILAG作为对抗保守管理的大量淋巴泄漏的主要治疗方法.

研究的目的:

评估ILAG的技术和临床成功,作为对症状性,大体积淋巴泄漏的第一线干预.
评估辅助淋巴干预措施的有效性,如栓塞,对于最初ILAG不耐药的病例.
报告与ILAG和/或栓塞治疗的多中心患者队列中的结果.

主要方法:

一项多中心的回顾性研究分析了从2017年到2023年在患有大量淋巴泄漏 (>500毫升/天) 的患者的淋巴干预措施.
ILAG的技术成功被定义为淋巴不透明化和泄漏证明;临床成功被定义为减少排水量 (<20毫升/24小时) 或停止无感的淋巴泄漏.
淋巴栓塞用于耐火性泄漏,使用粘合剂和/或线圈通过直接穿孔或透静脉管进行.

主要成果:

仅ILAG在32名患者中的14名患者 (44%) 中,在14天的中位数内取得了临床成功.
在12例耐药病例中,辅助栓塞在8例患者 (67%) 中成功,平均时间为8天.
所有淋巴干预的总体临床成功率为69% (32名患者中的22名患者) 平均11天,在泄漏部位,病因或栓塞技术与成功之间没有发现相关性.

结论:

内节淋巴血管学 (ILAG) 作为一种有效的第一线干预疗法,用于对保守措施无反应的显著淋巴泄漏.
在经过一段时间 (1-2周) 的警等待后,对于耐火病例来说,栓塞等辅助程序是有价值的.
多学科的讨论指导了关于ILAG重复或辅助程序的决定.

关键词:

查尔·莱尔 (Chyle Chyle) 是一个著名的作家.淋巴管造影是指淋巴管造影.淋巴系统淋巴系统

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