| Thoracic duct embolization (TDE) for non-traumatic chylous effusion: Experience in 34 patients. | |
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MedLine Citation:
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PMID: 22797603 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Thoracic duct embolization (TDE) is an acceptable alternative to treat traumatic chylothorax. The purpose of this study is to demonstrate efficacy of TDE to treat non-traumatic chylous effusions. METHODS: Retrospective review of 34 patients was conducted assessing technical and clinical success of TDE for non-traumatic chylous effusions. RESULTS: Thirty-four patients (mean age 59 yr, 27 female, 7 male) with non-traumatic chylous effusions underwent TDE. Presentations included 21 unilateral chylothoraces (61.8%), 9 bilateral chylothoraces (26.5%), 2 isolated chylopericardiums (5.9%), and 2 pleural effusions with chylopericardium (5.9%). TDE was technically successful in 24 of 34 patients (70.6%). Thoracic duct could not be catheterized in 4 of 34 (11.8%). Cisterna chyli was not visualized in 6 of 34 patients (17.6%), and thus TDE was not attempted. Follow up was available for 32 patients. Four lymphangiographic patterns were observed: (1) normal thoracic duct 17.6% (6/34), (2) occlusion of thoracic duct 58.8% (20/34), (3) failure to opacify thoracic duct 17.6% (6/34) and (4) extravasation of chyle 5.9% (2/34). Clinical success was varied with the lymphangiographic pattern. Clinical success rate in cases of (1) normal thoracic duct was 16% (1/6), (2) occlusion of thoracic duct was 75% (15/20), (3) failure to opacify thoracic duct was 16% (1/6), and (4) chyle extravasation was 50% (1/2). Lymphangiography alone cured 2 patients (6.5%). CONCLUSION: TDE was most successful in cases of thoracic duct occlusion and extravasation. Lymphangiography is important for identifying the cause of chylous effusions and selecting patients who benefit most from TDE. |
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Authors:
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Gregory J Nadolski; Maxim Itkin |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-10 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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