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Published in: CardioVascular and Interventional Radiology 6/2020

01-06-2020 | Neck Dissection | Case Report

Thoracic Duct Embolization in Post-neck Dissection Chylous Leakage: A Case Series of Six Patients and Review of the Literature

Authors: Amgad M. Moussa, Majid Maybody, Adrian J. Gonzalez-Aguirre, Jessica L. Buicko, Ashok R. Shaha, Ernesto Santos

Published in: CardioVascular and Interventional Radiology | Issue 6/2020

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Abstract

Chylous leak is a serious complication of neck dissection. Patients are often managed conservatively, and failure of conservative management necessitates surgical management, which adds to their morbidity. We present a case series demonstrating the value of thoracic duct embolization (TDE) in management of patients with chylous leaks following neck dissection who have failed conservative management and to review the literature on this specific application of TDE. Between 2011 and 2019, six patients underwent a total of seven TDE procedures. Lymphatic leak was identified, and clinical success was achieved in all patients, with one patient requiring repeat TDE. No minor or major complications were reported. In conclusion, TDE is a safe and effective tool in management of chylous leaks following neck dissection.
Literature
7.
go back to reference Van Goor AT, Kroger R, Klomp HM, de Jong MA, van den Brekel MW, Balm AJ. Introduction of lymphangiography and percutaneous embolization of the thoracic duct in a stepwise approach to the management of chylous fistulas. Head Neck. 2007;29:1017–23. https://doi.org/10.1002/hed.CrossRefPubMed Van Goor AT, Kroger R, Klomp HM, de Jong MA, van den Brekel MW, Balm AJ. Introduction of lymphangiography and percutaneous embolization of the thoracic duct in a stepwise approach to the management of chylous fistulas. Head Neck. 2007;29:1017–23. https://​doi.​org/​10.​1002/​hed.CrossRefPubMed
9.
go back to reference Chen C-Y, Chen Y-H, Shiau E-L, Liang H-L, Chang H-S, Chen H-C. Therapeutic role of ultrasound-guided intranodal lymphangiography in refractory cervical chylous leakage after neck dissection: report of a case and review of the literature. Head Neck. 2016;38:E54–60. https://doi.org/10.1002/hed.24134.CrossRefPubMed Chen C-Y, Chen Y-H, Shiau E-L, Liang H-L, Chang H-S, Chen H-C. Therapeutic role of ultrasound-guided intranodal lymphangiography in refractory cervical chylous leakage after neck dissection: report of a case and review of the literature. Head Neck. 2016;38:E54–60. https://​doi.​org/​10.​1002/​hed.​24134.CrossRefPubMed
20.
go back to reference Kawasaki R, Sugimoto K, Fujii M, et al. Therapeutic effectiveness of diagnostic lymphangiography for refractory postoperative chylothorax and chylous ascites: correlation with radiologic findings and preceding medical treatment. Am J Roentgenol. 2013;201(3):659–66. https://doi.org/10.2214/AJR.12.10008.CrossRef Kawasaki R, Sugimoto K, Fujii M, et al. Therapeutic effectiveness of diagnostic lymphangiography for refractory postoperative chylothorax and chylous ascites: correlation with radiologic findings and preceding medical treatment. Am J Roentgenol. 2013;201(3):659–66. https://​doi.​org/​10.​2214/​AJR.​12.​10008.CrossRef
Metadata
Title
Thoracic Duct Embolization in Post-neck Dissection Chylous Leakage: A Case Series of Six Patients and Review of the Literature
Authors
Amgad M. Moussa
Majid Maybody
Adrian J. Gonzalez-Aguirre
Jessica L. Buicko
Ashok R. Shaha
Ernesto Santos
Publication date
01-06-2020
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 6/2020
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-020-02475-9

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