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DOI: 10.1055/s-0031-1273941
Thoracic Duct Embolization for Chylous Leaks
Publikationsverlauf
Publikationsdatum:
22. März 2011 (online)
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ABSTRACT
Chylous leaks, such as chylothorax and chylopericardium, are uncommon effusions resulting from the leakage of intestinal lymphatic fluid from the thoracic duct (TD) and its tributaries, or intestinal lymphatic ducts. The cause can be either traumatic (thoracic surgery) or nontraumatic (idiopathic, malignancy). Treatment has traditionally consisted of dietary modification (nonfat diet) and/or surgery (TD ligation, pleurodesis). Thoracic duct embolization (TDE) has become a viable treatment alternative due to it high success rate and minimal complications. In this article, the authors describe the etiologies of chylothorax, patient population, outcomes, and long-term follow-up of TDE patients. Relevant lymphatic anatomy and physiology are reviewed, with special attention paid to the formation of the duct by tributaries at the cisterna chyli (CC). The technique of TDE is outlined, including bilateral pedal lymphangiography, TD cannulation, and embolic agents used for the procedure.
KEYWORDS
Thoracic duct embolization - chylothorax - chyle leak
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Maxim Itkin M.D.
Division of Interventional Radiology, Hospital of the University of Pennsylvania
3400 Spruce Street, Philadelphia, PA 19004
eMail: itkinmax@uphs.upenn.edu