Management of Unremitting Chylothorax by Percutaneous Embolization and Blockage of Retroperitoneal Lymphatic Vessels in 42 Patients
Section snippets
Study Group
Forty-two patients were treated during a period of 4 years for the management of symptomatic chylothorax (Table 1). All patients were referred from our institution's cardio-thoracic department because of high-output chylothorax or from outside institutions because of recurrent bouts of chylous pleural effusions, which could not be cured by diet, repeated thoracentesis, pleurodesis, or surgical TD ligation. These interventional procedures were performed immediately after the chylous effusion was
RESULTS
The ability to catheterize the TD after lymphography was completely dependent on the availability of suitably sized cisternae chyle or retroperitoneal lymphatic trunks; it was possible to successfully catheterize all uninterrupted lymphatic channels that were more than 2 mm in diameter. In 26 patients, the TD was catheterized via recognizable cisterna chyli in 22 procedures and retroperitoneal lymphatic trunks in seven procedures (Table 2).
In the 16 patients in whom lymphatic trunks could not
DISCUSSION
The TD is a 2–4-mm-wide duct with multiple valves, which arises from the cisterna chyli in the upper abdomen to empty either directly or through multiple branches into the left jugular or subclavian veins. The flow of chyle in the TD varies from 2 to 4 L/d. In the presence of an untreated chylothorax, the major loss of chyle, which contains 2%– 6% protein and 80% T-cells and electrolytes, can lead patients to experience life-threatening weakness, dehydration, edema, emaciation, and hemodynamic
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Cited by (0)
From the 2002 SCVIR Annual Meeting. Neither of the authors has identified a conflict of interest.