Endolymphatic Thoracic Duct Stent-Graft Reconstruction for Chylothorax: Approach, Technical Success, Safety, and Short-term Outcomes
| Autor: | Rajiv N. Srinivasa, Jeffrey Forris Beecham Chick, Anthony N. Hage, Ravi N. Srinivasa, Douglas C. Murrey, Joseph J. Gemmete |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Computed Tomography Angiography medicine.medical_treatment Prosthesis Design Chylothorax Thoracic duct Thoracic Duct 030218 nuclear medicine & medical imaging Blood Vessel Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Blood vessel prosthesis medicine Humans Embolization Computed tomography angiography medicine.diagnostic_test business.industry Lymphography Cisterna chyli Stent General Medicine Middle Aged Plastic Surgery Procedures medicine.disease Blood Vessel Prosthesis Treatment Outcome medicine.anatomical_structure Dose area product 030220 oncology & carcinogenesis Female Stents Surgery Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Annals of Vascular Surgery. 48:97-103 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2017.11.031 |
| Popis: | Background To report approach, technical success, safety, and short-term outcomes of thoracic duct stent-graft reconstruction for the treatment of chylothorax. Methods Two patients, 1 (50%) male and 1 (50%) female, with mean age of 38 years (range: 16–59 years) underwent endolymphatic thoracic duct stent-graft reconstruction between September 2016 and July 2017. Patients had radiographic left-sided chylothoraces ( n = 2) from idiopathic causes ( n = 1) and heart transplantation ( n = 1). In both (100%) patients, antegrade lymphatic access was used to opacify the thoracic duct after which retrograde access was used for thoracic duct stent-graft placement. Pelvic lymphangiography technical success, antegrade cisterna chyli cannulation technical success, thoracic duct opacification technical success, retrograde thoracic duct access technical success, thoracic duct stent-graft reconstruction technical success, ethiodized oil volume, contrast volume, estimated blood loss, procedure time, fluoroscopy time, radiation dose, clinical success, complications, deaths, and follow-up were recorded. Results Pelvic lymphangiography, antegrade cisterna chyli cannulation, thoracic duct opacification, retrograde thoracic duct access, and thoracic duct stent-graft reconstruction were technically successful in both (100%) patients. Mean ethiodized oil volume was 8 mL (range: 5–10 mL). Mean contrast volume was 13 mL (range: 5–20 mL). Mean estimated blood loss was 13 mL (range: 10–15 mL). Mean fluoroscopy time was 50.4 min (range: 31.2–69.7 min). Mean dose area product and reference air kerma were 954.4 μGmy 2 (range: 701–1,208 μGmy 2 ) and 83.5 mGy (range: 59–108 mGy), respectively. Chylothorax resolved in both (100%) patients. There were no minor or major complications directly related to the procedure. Conclusions Thoracic duct stent-graft reconstruction may be a technically successful and safe alternative to thoracic duct embolization, disruption, and surgical ligation for the treatment of chylothorax. Additional studies are warranted. |
| Databáze: | OpenAIRE |
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