Feasibility of percutaneous catheterization and embolization of the thoracic duct in dogs.
OBJECTIVE
To develop and determine the feasibility of a novel minimally invasive technique for percutaneous catheterization and embolization of the thoracic duct (PCETD) in dogs and to determine thoricic duct TD pressure at rest and during short-term balloon occlusion of the cranial vena cava (CrVC).


METHODS
Fifteen 7- to 11-month-old healthy mixed-breed dogs.


METHODS
Efferent intestinal lymphangiography was performed, and the cisterna chyli was punctured with a trochar needle percutaneously under fluoroscopic guidance. When access was successful, a guide wire was directed into the TD through the needle and a vascular access sheath was advanced over the guide wire. Thoracic duct pressure was measured at rest and during acute balloon occlusion of the CrVC. The TD was then embolized cranial to the diaphragm with a combination of microcoils and cyanoacrylate or ethylene vinyl alcohol.


RESULTS
Successful puncture of the cisterna chyli with advancement of a wire into the TD was possible in 9 of 15 dogs, but successful catheterization was possible in only 5 of 9 dogs. Acute balloon occlusion of the CrVC led to a substantial TD pressure increase in 4 of 4 dogs, and embolization of the TD was successful in 4 of 4 dogs.


CONCLUSIONS
PCETD can successfully be performed in healthy dogs; however, this minimally invasive technique cannot currently be recommended for routine treatment of chylothorax, in part because of the technically demanding nature of the procedure. An increase in jugular venous pressure led to an increase in TD pressure, potentially predisposing some dogs to developing chylothorax.
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
Ameet
A
Singh
Brigitte A
BA
Brisson
M Lynne
ML
O'Sullivan
Jeffrey A
JA
Solomon
Sarah
S
Malek
Stephanie
S
Nykamp
Jeff J
JJ
Thomason
D000818:Animals; D021721:Balloon Occlusion / Q000662:veterinary; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000662:veterinary*; D002916:Chylothorax / Q000601:surgery / Q000628:therapy / Q000662:veterinary*; D004283:Dog Diseases / Q000601:surgery / Q000628:therapy*; D004285:Dogs; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D008220:Lymphography / Q000662:veterinary; D008297:Male; D013897:Thoracic Duct / Q000098:blood supply / Q000502:physiology* / Q000601:surgery