Percutaneous embolization of lymphatic fistulae as treatment for protein-losing enteropathy and plastic bronchitis in patients with failing Fontan circulation

Autor: Bjorn Cools, Geert Maleux, Jelena Hubrechts, Marc Gewillig, Ruth Heying, Jacoba Louw, Emma Storme, Sofie Malekzadeh‐Milanii, Stephen C. Brown, Derize Boshoff, Stefan Frerich
Přispěvatelé: Kindergeneeskunde, MUMC+: MA Medische Staf Kindergeneeskunde (9), RS: FHML non-thematic output
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Percutaneous
Fistula
medicine.medical_treatment
030204 cardiovascular system & hematology
Fontan Procedure
0302 clinical medicine
Paratracheal
Medicine
Treatment Failure
030212 general & internal medicine
Embolization
Child
THORACIC-DUCT
Protein losing enteropathy
plastic bronchitis
General Medicine
Enbucrilate
Embolization
Therapeutic
congenital heart disease
Treatment Outcome
medicine.anatomical_structure
Lymphatic system
Lipiodol
Cardiology and Cardiovascular Medicine
INTERVENTION
medicine.drug
Heart Defects
Congenital
medicine.medical_specialty
Adolescent
protein losing enteropathy
Protein-Losing Enteropathies
Thoracic duct
03 medical and health sciences
n-butyl cyanoacrylate
MANAGEMENT
Humans
Radiology
Nuclear Medicine and imaging
lymphangiography
Bronchitis
Lymphatic Diseases
Retrospective Studies
business.industry
DECOMPRESSION
ADULTS
medicine.disease
Surgery
lymphatic embolization
Feasibility Studies
EXPERIENCE
Liver function
business
Zdroj: Catheterization and Cardiovascular interventions, 94(7), 996-1002. Wiley
ISSN: 1522-1946
Popis: Background To determine the feasibility and clinical result of selective embolization of hepatoduodenal or paratracheal lymphatics in Fontan patients with protein-losing enteropathy (PLE) or plastic bronchitis (PB). Methods Dilated lymph vessels in periportal (PLE) or paratracheal (PB) position were percutaneously punctured with a 22G Chiba needle. Intralymphatic position was confirmed by water soluble contrast injection with drainage to hepatoduodenal or tracheal fistulae. After flushing with 10% glucose solution, occlusion of hepatoduodenal or paratreacheal lymphatics was effected by injection of 1-4 cc mixture 4/1 of Lipiodol/n-butyl cyanoacrylate (n-BCA; Histoacryl). Results Seven patients with proven PLE were treated with periportal lymphatic embolization 10.7 (range: 6.6-13.5) years after the Fontan operation. The Fontan operation was performed at a median age of 3.7 (range: 2.9-5.7) years and PLE started a median of 3.1 (range: 0.9-4.7) years later. Five patients required a second procedure 2-8 months later. Complications were limited (spillage of glue in portal branch, transient cholangitis, and caustic duodenal bleeding). Six of seven patients reported significant improvement in quality of life and normalization of albumin levels after limited follow-up (p
Databáze: OpenAIRE
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