Reversed Approach through Lymphocele/Lymphatic Fluid Collection for Glue Embolization of Injured Lymphatic Vessels

Hur, Joonho; Hur, Saebeom; Shin, Ji Hoon; Kwon, Se Hwan; Hyun, Dongho; Yoon, Jehong

doi:10.1016/j.jvir.2020.10.014

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…However, it may be suboptimal in high-flow lymphatic leakage, or when a ruptured lymphocele communicates with the peritoneum, or there is direct intraperitoneal lymphorrhea. 10 Furthermore, sclerotherapy also may require multiple treatment sessions. 10 More recently, case reports and small case series have reported success utilizing percutaneous coil or glue embolization either via direct percutaneous needle targeting of the leaking lymphatic under CT or fluoroscopy at time of LAG.…”

Section: Discussionmentioning

confidence: 99%

“…The authors reported decreasing fluid output from leak sites with mean of 465 mL per day pre-embolization to 42 mL per day post embolization which allowed for drain removal in all but one patient. 10 Had embolization not successfully treated the leak in the index case, surgical intervention had been planned with possible fibrin glue, cautery, or surgical ligation to terminate the leak. As LAG and CT demonstrated the site of leak at the level of L2 posterior to aorta, the likelihood of surgical cure was improved.…”

Section: Discussionmentioning

confidence: 99%

“…10 Furthermore, sclerotherapy also may require multiple treatment sessions. 10 More recently, case reports and small case series have reported success utilizing percutaneous coil or glue embolization either via direct percutaneous needle targeting of the leaking lymphatic under CT or fluoroscopy at time of LAG. 11 The largest reported series of 8 patients undergoing percutaneous translymphocele embolization (the technique used in the index case) demonstrated a clinical success rate of 88%.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Translymphocele Embolization of Retroperitoneal Lymphatic Leak

Bent

2021

Vasc Endovascular Surg

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Iodized oil-based lymphangiography (LAG) is a well-established diagnostic exam during the workup of postoperative lymphatic leaks. Computed tomography (CT) has been shown to be a useful complement to optimize treatment planning and can easily be performed after conventional LAG. The treatment options for lymphatic leaks include conservative dietary modification, sclerotherapy, embolization, and surgery. We present a case of a 48-year-old man who developed a symptomatic left retroperitoneal lymphatic fluid collection after left nephrectomy, complicated by postoperative retroperitoneal abscess. Retroperitoneal duct leak was confirmed via ultrasound-guided intranodal LAG and post-LAG CT. This leak was successfully managed with N-butyl cyanoacrylate glue embolization of the leaking lymphatics via fluoroscopic-guided catheterization of the leak via percutaneous access through the lymphatic fluid collection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Percutaneous Translymphocele Embolization of Retroperitoneal Lymphatic Leak

Bent

2021

Vasc Endovascular Surg

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“…4 ). Examples of these techniques have been previously reported [ 10 17 ]. When lymphangiography fails to reveal a leak, mesenteric lymphangiography may be considered.…”

Section: Classification Of Lymphatic Disorders From the Perspective O...mentioning

confidence: 99%

“…Meanwhile, for larger fluid collections, the inflow of lymph should be interrupted to stop the lymphopseudoaneurysm from filling. This can be achieved by either targeting the inflow channel below the leak [ 9 78 ] or using a microcatheter to navigate from the lymphopseudoaneurysm into the inflow channel [ 10 17 ]. In theory, strategies that interrupt lymphatic inflow should be more effective than lymphopseudoaneurysm embolization.…”

Section: Treatment Of Lymphatic Disordersmentioning

confidence: 99%

Lymphatic Intervention, the Frontline of Modern Lymphatic Medicine: Part II. Classification and Treatment of the Lymphatic Disorders

et al. 2023

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Lymphatic disorders encompass a broad spectrum of diseases involving the lymphatic system, ranging from traumatic lymphatic leaks to lymphatic malformations. Lymphatic disorders can be categorized into traumatic and non-traumatic disorders according to their etiology. These two categories may be further divided into subgroups depending on the anatomical location of the lymphatic pathology and their association with clinical syndromes. Thoracic duct embolization was a milestone in the field of lymphatic intervention that encouraged the application of percutaneous embolization techniques to treat leaks and reflux disorders in the lymphatic system. Additional access routes for embolization, including retrograde thoracic duct and transhepatic lymphatic access, have also been developed. This article comprehensively reviews a variety of options for the treatment of lymphatic disorders, from conservative management to the most recent embolization techniques.

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