title: Delayed complications following technically successful thoracic duct embolization.
abstract: OBJECTIVE
  Thoracic duct (TD) embolization (TDE) has become a universally accepted treatment of chylous pleural effusion. However, the long-term sequelae of occlusion of the TD are unknown. The objective of the present study was to determine the rate of delayed complications after technically successful TDE.
  
  
  METHODS
  A total of 169 patients underwent TDE for symptomatic chylous effusion between January 1, 1994, and June 11, 2010. In 106 of 169 cases (63%), TDE embolization was technically successful. Retrospective review of these charts was performed, and patients were interviewed to determine the development of lower-extremity edema, diarrhea, abdominal swelling, and other symptoms.
  
  
  RESULTS
  Follow-up information was available in 78 of 106 patients (73.6%). Mean length of follow-up was 34 months. During follow-up, 32 patients (41%) died of causes unrelated to TDE, and 46 (59%) were alive at the end of follow-up. The families of three deceased patients were available for interview. Four of 49 patients (8%) had chronic leg swelling that was probably related to the procedure, three (6%) had abdominal swelling, and six (12%) had chronic diarrhea. In four of these six cases, diarrhea was considered "probably related" to the procedure. Overall, a 14.3% rate of probably-related long-term complications after TDE was recorded.
  
  
  CONCLUSIONS
  Chronic diarrhea and lower-extremity swelling may be related to TDE and should be part of informed consent before the procedure. A prospective follow-up study is needed to further establish these relationships.
authors: Department of Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104, USA.
authors: David
authors: D
authors: Laslett
authors: Scott O
authors: SO
authors: Trerotola
authors: Maxim
authors: M
authors: Itkin
mesh_terms: D000328:Adult; D000368:Aged; D002916:Chylothorax / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013897:Thoracic Duct; D016896:Treatment Outcome