Where Have All the Punctures Gone? An Analysis of Thoracic Duct Embolizations.
J Vasc Interv Radiol
; 31(1): 74-79, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-31771898
ABSTRACT
PURPOSE:
To determine how frequently and how severely intra-abdominal structures are affected by transabdominal thoracic duct embolization (TDE). MATERIALS ANDMETHODS:
Thirty-five TDE procedures in 35 patients (22 male; mean age, 57 y; age range, 10-79 y) with therapy-refractory chylous effusions were evaluated in which radiopaque embolization material outlined the access route on postinterventional CT. CT data were analyzed by 2 TDE-experienced radiologists. Abdominal structures and organs transgressed by the access route were recorded, and findings were correlated with clinical postinterventional course with follow-up of at least 44 days.RESULTS:
Intra-abdominal structures/organs transgressed most often by the access route were the liver (n = 28), crus of the diaphragm (n = 25), pancreas (n = 14), portal vein (n = 10), duodenum (n = 7), inferior vena cava (n = 5), colon (n = 3), left renal vein (n = 2), pleura (n = 2), pericardium (n = 2), and gastric sleeve (n = 2). Pancreatitis was observed in 1 of 14 patients after pancreatic transgression. One case of clinically occult pulmonary glue migration occurred on catheter pullback through the left renal vein. Biliary peritonitis was observed after gallbladder puncture, necessitating cholecystectomy in 1 of 2 transbiliary punctures. No other relevant procedure-related complications such as hemorrhages or infectious complications were observed.CONCLUSIONS:
Despite transgression of intra-abdominal structures, puncture- and access-related complications of TDE are rare. Transpancreatic manipulations are reasonably well tolerated.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ducto Torácico
/
Tomografia Computadorizada por Raios X
/
Quilotórax
/
Embolização Terapêutica
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article