A featured abstract to be presented Wednesday afternoon concludes that intranodal lymphangiography (IL) for thoracic duct embolization (TDE) offers a safe alternative to surgical ligation for traumatic injury to the thoracic duct.
Presenting author Andrew Kozlov, MD, from the Hospital of the University of Pennsylvania, will discuss his team’s abstract, “Comparison of pedal and intranodal lymphangiography for thoracic duct embolization (TDE) of traumatic chylous leaks,” during the “Lymphatic” scientific session, which takes place from 3 to 4:30 p.m. in Room 143C. Dr. Kozlov will provide a short review of lymphangiography and TDE since it’s a relatively uncommon procedure and share his institution’s experience with IL in comparison with pedal lymphangiography (PL).
“Some might be surprised that direct nodal injection appears to be similarly successful as traditional pedal lymphangiography but with much shorter procedural times,” he said.
Dr. Kozlov and his colleagues reviewed records of 173 patients from 2002 to 2016 who were referred for TDE to treat traumatic chylous leaks. TDEs with IL were performed on 85 patients, while 88 patients had TDEs with PL. Site and etiology of the leak, sex and age did not differ between the groups. Researchers reviewed records based on mechanism and site of chylous leak, procedural time and technical and clinical success.
IL reduced the average total procedure time by more than 60 minutes while delivering similar technical and clinical success as PL. Complications were similar in both groups, but three cases of leg edema or wound infection happened in the PL group, with none in the IL group.
The results, Dr. Kozlov said, support adopting IL for TDEs. He also wants Wednesday’s abstract presentation to inspire more research into understanding the pathophysiology of lymphatic disease.
“Since direct nodal lymphangiography is less technically demanding and faster than pedal lymphangiography, I suspect more interventional radiologists will feel comfortable treating traumatic chylous leaks,” Dr. Kozlov said.