Percutaneous lymphatic embolization of abnormal pulmonary lymphatic flow as treatment of plastic bronchitis

Abstract

Purpose: To assess the outcome of lymphatic approach for patients with postoperative lymphoceles that are refractory to sclerotherapy. Materials: During a period of one year, five patients with lymphoceles that had developed after gynecologic surgery were treated by percutaneous embolization of the leaking lymphatic channels using N-butyl cyanoacrylate. We assessed the outcome of these patients after the procedure. Results: All five patients had a history of gynecologic surgery involving extensive dissection of lymph nodes in the pelvic cavity. Two patients had developed lymphoceles that failed to regress despite multiple attempts of sclerotherapy using absolute ethanol. Two other patients had lymphoceles that were leaking into the peritoneal cavity and therefore contraindicated for sclerotherapy. A fifth patient had a recurrent lymphocele that had previously been treated by lymphangiography without embolization. After intranodal lymphangiography followed by percutaneous embolization of the leaking lymphatic channels, the lymphoceles successfully regressed and drainage catheters were uneventfully removed. No procedure-related complications were seen. Conclusions: Percutaneous lymphatic embolization offers a potential bail-out option for the treatment of lymphoceles that are either refractory to sclerotherapy or are contraindicated for sclerotherapy due to rupture.

Pediatric Lymphatics Review: Current State and Future Directions

“…22 Percutaneous embolization of the abnormal lymphatic vessels carrying this flow into the lung parenchyma was reported to be successful in the resolution of pleural effusion and improvement of pulmonary function in these patients. 22,23…”