Nikolas Kortes1, Boris Radeleff2, Christof-Matthias Sommer2, Nadine Bellemann2, Katja Ott3, Götz Martin Richter4, Hans-Ulrich Kauczor2, Ulrike Stampfl2. 1. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120. Electronic address: nikolas.kortes@med.uni-heidelberg.de. 2. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120. 3. Department of Surgery, University Hospital Heidelberg, INF 110, Heidelberg 69120. 4. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120; Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany.
Abstract
PURPOSE: To evaluate therapeutic lymphangiography and computed tomography (CT)-guided sclerotherapy for the treatment of refractory inguinal, pelvic, abdominal, and thoracic lymphatic leakage. MATERIALS AND METHODS: Between January 2008 and April 2011, 18 patients with refractory lymphatic leakage were treated with therapeutic lymphangiography. Additionally, 10 of these 18 patients underwent CT-guided sclerotherapy with injection of ethanol at the site of the leakage. In the delayed sclerotherapy group (n = 5), the sclerotherapy procedure was performed when the leak persisted after therapeutic lymphangiography. In the immediate sclerotherapy group (n = 5), sclerotherapy was performed on the same day as lymphangiography. The sites of the lymphatic leakage were as follows: inguinal leakage in 8 patients, pelvic leakage in 4 patients, abdominal leakage in 2 patients, and thoracic leakage in 4 patients. Data collected included technical success, clinical success, and procedural complications. RESULTS: Lymphangiography was technically successful in all patients. In eight patients undergoing therapeutic lymphangiography alone, the clinical success rate was 75%, and the drainage catheter could be removed in six patients after the treatment. Lymphangiography followed by immediate sclerotherapy was clinically successful in four of five patients. Lymphangiography combined with delayed sclerotherapy was clinically successful in three of five patients. Overall, the clinical success rate was 72% (13 of 18 patients). One minor complication occurred. CONCLUSIONS: Therapeutic lymphangiography alone or in combination with CT-guided sclerotherapy is a promising treatment option for the management of refractory lymphatic leakage.
PURPOSE: To evaluate therapeutic lymphangiography and computed tomography (CT)-guided sclerotherapy for the treatment of refractory inguinal, pelvic, abdominal, and thoracic lymphatic leakage. MATERIALS AND METHODS: Between January 2008 and April 2011, 18 patients with refractory lymphatic leakage were treated with therapeutic lymphangiography. Additionally, 10 of these 18 patients underwent CT-guided sclerotherapy with injection of ethanol at the site of the leakage. In the delayed sclerotherapy group (n = 5), the sclerotherapy procedure was performed when the leak persisted after therapeutic lymphangiography. In the immediate sclerotherapy group (n = 5), sclerotherapy was performed on the same day as lymphangiography. The sites of the lymphatic leakage were as follows: inguinal leakage in 8 patients, pelvic leakage in 4 patients, abdominal leakage in 2 patients, and thoracic leakage in 4 patients. Data collected included technical success, clinical success, and procedural complications. RESULTS: Lymphangiography was technically successful in all patients. In eight patients undergoing therapeutic lymphangiography alone, the clinical success rate was 75%, and the drainage catheter could be removed in six patients after the treatment. Lymphangiography followed by immediate sclerotherapy was clinically successful in four of five patients. Lymphangiography combined with delayed sclerotherapy was clinically successful in three of five patients. Overall, the clinical success rate was 72% (13 of 18 patients). One minor complication occurred. CONCLUSIONS: Therapeutic lymphangiography alone or in combination with CT-guided sclerotherapy is a promising treatment option for the management of refractory lymphatic leakage.
Authors: C M Sommer; C C Pieper; F Offensperger; F Pan; H J Killguss; J Köninger; M Loos; T Hackert; M Wortmann; T D Do; G Maleux; G M Richter; H U Kauczor; J Kim; S Hur Journal: Langenbecks Arch Surg Date: 2021-04-12 Impact factor: 3.445
Authors: Florian Streitparth; Sebastian Theurich; Tina Streitparth; Osman Öcal; David Cordas Dos Santos; Wilhelm Flatz Journal: Cardiovasc Intervent Radiol Date: 2021-08-05 Impact factor: 2.740